Oral & Maxillofacial surgeon, Dept. of Oral and Maxillofacial Surgery, Fujairah Hospital, Emirates Health Services, United Arab Emirates; Dept. of Oral and Maxillofacial Surgery/Oral Pathology, Amsterdam University Medical Centers and Academic Centre for Dentistry Amsterdam (ACTA), Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
Oral & Maxillofacial surgeon, Dept. of Oral and Maxillofacial Surgery, Fujairah Hospital, Emirates Health Services, United Arab Emirates.
Br J Oral Maxillofac Surg. 2022 Nov;60(9):1184-1191. doi: 10.1016/j.bjoms.2022.07.007. Epub 2022 Jul 29.
Traditional surgical planning (TSP) and virtual surgical planning (VSP) have been used in bimaxillary osteotomy planning. The time is taken in the planning and operating stages, and the working/doctor/total time of either approach are useful determinants of the efficiency of the operating method and quality of care. This systematic review and meta-analysis examined if VSP has a comparative advantage over TSP in the bimaxillary osteotomy. Cochrane Library, PubMed, EMBASE, and Google Scholar were used as databases to collect studies that met the outlined inclusion criteria based on PRISMA. Eight of 759 studies were considered to meet the eligibility criteria, and six fit for meta-analysis. The findings demonstrated significant VSP advantage over TSP in planning time (Z = 3.97 (p < 0.00001), WMD = -5.29 (CI -7.90 to -2.68)). While more time-efficient than TSP, the difference with VSP was not significant during surgery (Z = 0.44 (p = 0.66), WMD = -0.10 (CI -0.51 to 0.34)). The study used random effects due to the high I of the planning mean differences. The continued evolution of VSP and improved application knowledge will be important in reducing the time of planning and surgery, thus improving the outcomes of the complex bimaxillary osteotomy. The current evidence shows that VSP significantly performs better than TSP in reducing the bimaxillary osteotomy planning time, but the timing difference is not significant during surgery. Future analysis will benefit from using studies with standard research and reporting metrics and procedures, thus improving evidence-based clinical practice.
传统的手术规划（TSP）和虚拟手术规划（VSP）已用于双颌骨切开术的规划。规划和手术阶段所花费的时间，以及两种方法的工作/医生/总时间是衡量手术方法效率和护理质量的有用决定因素。本系统评价和荟萃分析检查了 VSP 是否在双颌骨切开术中相对于 TSP 具有比较优势。Cochrane 图书馆、PubMed、EMBASE 和 Google Scholar 被用作数据库，以根据 PRISMA 收集符合既定纳入标准的研究。在 759 项研究中，有 8 项被认为符合资格标准，其中 6 项适合进行荟萃分析。研究结果表明，在规划时间方面，VSP 相对于 TSP 具有显著优势（Z = 3.97（p < 0.00001），WMD = -5.29（CI -7.90 至 -2.68））。虽然 VSP 比 TSP 更节省时间，但在手术过程中，两者之间的差异并不显著（Z = 0.44（p = 0.66），WMD = -0.10（CI -0.51 至 0.34））。由于规划平均差异的 I 值较高，因此该研究使用了随机效应。VSP 的不断发展和应用知识的提高将有助于减少规划和手术时间，从而改善复杂的双颌骨切开术的结果。目前的证据表明，VSP 在减少双颌骨切开术规划时间方面明显优于 TSP，但在手术过程中，两者之间的时间差异并不显著。未来的分析将受益于使用具有标准研究和报告指标及程序的研究，从而改善基于证据的临床实践。
