Department of Oral and Maxillofacial Surgery, Dammam Medical Complex, Ministry of Health in Saudi Arabia in a Training Program at the Department of Oral and Maxillofacial Surgery, Dental Hospital.
Department of Orthodontics.
J Craniofac Surg. 2022;33(5):1479-1483. doi: 10.1097/SCS.0000000000008407. Epub 2021 Dec 13.
To evaluate the surgical accuracy of positioning the maxilla in patients with skeletal class II malocclusion using computer-aided design and computer-aided manufacturing (CAD/ CAM)-assisted orthognathic surgery.
The samples consisted of 10 patients with skeletal class II malocclusion, whose cone-beam computed tomographys taken before and immediately after surgery were available and who underwent bimaxillary orthognathic surgery by a single surgeon using Le Fort I osteotomy and bilateral sagittal split ramus osteotomy at the Department of Oral and Maxillofacial Surgery, Seoul National University Dental Hospital, Seoul, South Korea between January 2018 and December 2019. After virtual surgical planning was performed using the FACEGIDE system (Korea), surgical cutting guides, intermediate splints, and custom-made titanium mini-plates were fabricated using CAD/CAM technique. Using 8 landmarks (anterior nasal spine, point A, #16, #13, contact point between #11 and #21, #23, #26, posterior nasal spine), the mean differences between the virtually planned (Virtual) and actual postsurgical position of the maxilla (Actual) in the three-dimensional coordinates (ΔActual-Virtual) and their mean absolute deviations were investigated.
The mean differences of 8 landmarks were 0.42 mm left side movement in the transverse coordinate, 0.15 mm forward movement in the sagittal coordinate and 0.10 mm downward movement in the vertical coordinate. Their mean absolute deviations were 0.98, 0.67, and 0.62 mm in the sagittal, vertical, and transverse coordinates, respectively.
Since the mean difference was less than 0.5 mm and the range of error was less than 1.0 mm, CAD/CAM-assisted orthognathic surgery might have a high degree of surgical accuracy and clinical relevance in the positioning of the maxilla.
评估计算机辅助设计和计算机辅助制造（CAD/CAM）辅助正颌手术中定位上颌骨的手术精度。
该样本包括 10 名骨骼 II 类错畸形患者，这些患者在韩国首尔大学牙科医院口腔颌面外科接受了 Le Fort I 截骨术和双侧矢状劈开下颌骨截骨术的双颌正颌手术，术前和术后即刻的锥形束 CT 可用。在 2018 年 1 月至 2019 年 12 月期间，使用韩国的 FACEGIDE 系统进行虚拟手术规划后，使用 CAD/CAM 技术制造了手术切割导板、中间夹板和定制钛微型板。使用 8 个标志点（前鼻棘、A 点、#16、#13、#11 和 #21 之间的接触点、#23、#26、后鼻棘），研究了上颌骨在三维坐标中的虚拟规划（虚拟）和实际术后位置（实际）之间的平均差异（Δ实际-虚拟）及其平均绝对偏差。
8 个标志点的平均差异为 0.42mm 左侧横向移动、0.15mm 矢状向前移动和 0.10mm 垂直向下移动。它们的平均绝对偏差分别为 0.67mm、0.62mm 和 0.98mm 在矢状、垂直和横坐标轴上。
由于平均差异小于 0.5mm，误差范围小于 1.0mm，CAD/CAM 辅助正颌手术可能在上颌骨定位方面具有高度的手术精度和临床相关性。
