University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
University of Heidelberg, Department of Oral and Maxillofacial Surgery, Im Neuenheimer Feld 400, D-69120, Heidelberg, Germany.
J Craniomaxillofac Surg. 2020 Jul;48(7):653-660. doi: 10.1016/j.jcms.2020.05.003. Epub 2020 May 19.
To assess the accuracy of laser-melted patient-specific implants (PSI) with regard to a preoperative virtual treatment plan for genioplasty based on a new analysis method without the use of landmarks.
A retrospective evaluation of a cohort of Class II and Class III patients who had undergone virtually planned orthognathic surgery (including genioplasty) was carried out. The preoperative virtual treatment plan and the postoperative outcome were fused to calculate the translational and rotational discrepancies between the 3D planning and the actual surgical outcome.
The accuracy of left/right positioning was 0.25 ± 0.28 mm (p < 0.001), that of anterior/posterior positioning was 0.70 ± 0.64 mm (p < 0.001), and that of up/down-positioning was 0.45 ± 0.38 mm (p < 0.001). The rotational discrepancies were less than 2 deg. The virtually planned and postoperative positions of the chin differed significantly from each other (p < 0.001 for all rotational and translational discrepanices).
The findings demonstrate that PSIs can transfer the planned virtual genioplasty into the operation theatre with small but significant deviations. However, since no conclusions can be drawn from the results regarding surgical success in terms of shaping the soft tissue profile as well as the esthetic result, no superiority of PSI over traditional plate osteosynthesis can be demonstrated.
评估激光熔融的个体化植入物（PSI）在不使用标志点的新分析方法下，针对基于术前虚拟正颌手术计划（包括颏成形术）的准确性。
回顾性评估了一组接受过虚拟计划正颌手术（包括颏成形术）的 II 类和 III 类患者。将术前虚拟治疗计划和术后结果融合，以计算 3D 规划与实际手术结果之间的平移和旋转差异。
左右定位的准确性为 0.25±0.28mm（p<0.001），前后定位的准确性为 0.70±0.64mm（p<0.001），上下定位的准确性为 0.45±0.38mm（p<0.001）。旋转差异小于 2 度。颏部的虚拟规划和术后位置差异显著（所有旋转和平移差异均 p<0.001）。
研究结果表明，PSI 可以将计划的虚拟颏成形术转移到手术室，只有微小但显著的偏差。然而，由于无法从结果中得出关于塑造软组织轮廓和美学效果的手术成功的结论，因此无法证明 PSI 优于传统的板骨合成术。
