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两种计算机辅助手术模拟方法在虚拟手术规划中准确性的比较研究。

A comparative study of the accuracy between two computer-aided surgical simulation methods in virtual surgical planning.

机构信息

Oral and Maxillofacial Surgery, Hospital Das Clínicas, University of São Paulo (USP), Rua Dr Eneas de Carvalho, 255, 05403-010, São Paulo, São Paulo, Brazil.

Oral and Maxillofacial Surgery, State University of Maringá (UEM), Avenida Mandacaru, 1550, 87080-000, Maringá, Paraná, Brazil.

出版信息

J Craniomaxillofac Surg. 2021 Feb;49(2):84-92. doi: 10.1016/j.jcms.2020.12.002. Epub 2020 Dec 11.

Abstract

OBJECTIVE

The aim of this retrospective and observational study was to compare the accuracy of two different virtual surgical planning (VSP) protocols, namely, the CASS method and the modified CASS method.

MATERIALS AND METHODS

The patients underwent bimaxillary orthognathic surgery, planned using either the CASS method or the modified CASS method. Linear and angular discrepancies between the VSP outcome and postoperative outcome for both groups were compared for maxilla, mandible, and chin segments. Aside from the comparison between both groups, additional criteria were used to determine the accuracy of the protocol based on a linear and angular difference between planned and actual outcomes of less than 2 mm and 4°, respectively. The intergroup comparisons were performed by one-way ANOVA, with the level of significance set at 5%.

RESULTS

A total of 21 patients, of both genders, were assigned into group I (n = 11), planned with the CASS method, and group II (n = 10), planned with the modified CASS method. Both the CASS and modified CASS methods presented similar accuracy with regard to linear differences for the maxilla, mandible, and chin segments, except for ΔX for the mandibular segment, where the modified CASS method showed slightly better accuracy. However, there was a statistically significant difference with regard to angular differences in the chin segment, with the CASS method shown to be the more accurate. Aside from Δpitch for the chin segment, no linear or angular differences exceeded 2 mm or 4°.

CONCLUSION

Although statistically significant differences were found with regard to angular measurements in the chin segment, the accuracy of the modified CASS method for virtual planning can be considered as clinically equivalent, with a performance comparable to that of the CASS method.

摘要

目的

本回顾性观察研究旨在比较两种不同虚拟手术规划(VSP)方案,即 CASS 方法和改良 CASS 方法的准确性。

材料与方法

患者接受双颌正颌手术,分别使用 CASS 方法或改良 CASS 方法进行计划。比较两组中上颌、下颌和颏骨的 VSP 结果与术后结果的线性和角度差异。除了两组之间的比较外,还使用了基于计划和实际结果之间的线性和角度差异分别小于 2 毫米和 4°的附加标准来确定方案的准确性。通过单向方差分析进行组间比较,显著性水平设置为 5%。

结果

共 21 名患者(男女各 11 名)被分配到 CASS 方法组(n=11)和改良 CASS 方法组(n=10)。两种方法在预测上颌、下颌和颏骨的线性差异方面具有相似的准确性,除了下颌骨节段的 ΔX 外,改良 CASS 方法的准确性稍高。然而,在颏骨节段的角度差异方面存在统计学显著差异,CASS 方法的准确性更高。除了颏骨节段的 Δpitch 外,没有线性或角度差异超过 2 毫米或 4°。

结论

尽管在颏骨节段的角度测量方面发现了统计学显著差异,但改良 CASS 方法的虚拟规划准确性可被认为具有临床等效性,与 CASS 方法的性能相当。

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