Department of Stomatology, The Affiliated Hospital of Qingdao University, No. 16, Jiangsu Road, Qingdao 266003, China; School of Stomatology, Qingdao University, Qingdao 266003, China.
Faculty of Information Technology, Macau University of Science and Technology, Macao 999078, China.
J Plast Reconstr Aesthet Surg. 2022 Jul;75(7):e15-e22. doi: 10.1016/j.bjps.2022.02.055. Epub 2022 Mar 5.
Intermaxillary fixation screw (IMFS) implantation is a common procedure in orthognathic surgery (OGS) performed to the temporary maxillary-mandibular fixation and stable bite relationships. The study aims to assess the accuracy of IMFS implantation with a digital guide to reduce the occurrence of root damage.
This prospective study involved 40 patients undergoing OGS at the Affiliated Hospital of Qingdao University from August 2017 to May 2021. The patients were randomly divided into two groups according to whether the IMFS implantation was with or without digital guide (20 patients in the experimental group and 20 controls). The digital guides used in the experimental group were designed according to a virtual implantation plan and printed using stereolithography. In the control group, IMFSs were directly implanted by a surgeon based on clinical experience. Postoperatively, cone-beam computed tomography was performed to compare root proximity of IMFSs between the two groups and verify the accuracy of IMFS placement.
In the experimental group, there was no case of root damage, the incidence of the periodontal ligament (PDL) injured was 22.1%, and 77.9% IMFSs were placed without contacting adjacent anatomic structures. In the control group, the incidence of root damage had been up to 20.8%, 31.7% IMFSs injured the PDL, and only 47.5% IMFSs were placed between the roots (P < 0.001).
IMFSs can be placed more accurately with surgical guides, reducing the incidence of root and PDL damages.
颌间固定螺钉（IMFS）植入术是正颌外科（OGS）中常见的一种手术，用于临时上下颌固定和稳定咬合关系。本研究旨在评估数字化导板辅助 IMFS 植入术的准确性，以减少根损伤的发生。
本前瞻性研究纳入 2017 年 8 月至 2021 年 5 月在青岛大学附属医院行 OGS 的 40 例患者。根据是否使用数字化导板将患者随机分为两组（实验组 20 例，对照组 20 例）。实验组的数字化导板根据虚拟植入计划设计，并使用立体光刻技术打印。对照组的 IMFS 则由外科医生根据临床经验直接植入。术后采用锥形束 CT 比较两组 IMFS 与根的距离，验证 IMFS 放置的准确性。
实验组无根损伤病例，牙周膜（PDL）损伤发生率为 22.1%，77.9%的 IMFS 未接触邻近解剖结构。对照组根损伤发生率达 20.8%，31.7%的 IMFS 损伤 PDL，仅有 47.5%的 IMFS 位于根间（P<0.001）。
使用手术导板可更准确地放置 IMFS，减少根和 PDL 损伤的发生。
