Chen Chen, Sun Ningning, Jiang Chunmiao, Liu Yanshan, Sun Jian
Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Department of Emergency Intensive Care Unit, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Korean J Orthod. 2021 Sep 25;51(5):321-328. doi: 10.4041/kjod.2021.51.5.321.
To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome.
The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Realtime Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated.
The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases.
This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.
通过比较术前规划与术后结果，检验计算机辅助术中导航（Ci-Navi）在双颌正颌手术中的准确性。
该研究纳入了45例计划接受双颌正颌手术的先天性牙颌面畸形患者。使用Mimics软件模拟虚拟双颌正颌手术。术中，使用截骨导板对上颌进行Le Fort I截骨术。在进行上颌Le Fort I截骨术和下颌双侧矢状劈开截骨术后，使用咬合夹板固定移动后的上颌和下颌远心段，形成颌骨复合体（MMC）。使用实时Ci-Navi将MMC引导至指定方向。当关注面部对称性和骨骼协调性时，使用Ci-Navi进行下颌下缘的骨成形术。计算术前规划与术后结果之间的线性和角度差异。
平均线性差异为0.79毫米（上颌：0.62毫米，下颌：0.88毫米），总体平均角度差异为1.20°。40例患者中，上切牙点至法兰克福水平面、面中矢状面和冠状面的观察差异<1毫米。
本研究证明了Ci-Navi在双颌正颌手术中对骨段准确定位的作用。发现Ci-Navi是术中准确传递手术计划的可靠方法。
