Olejnik Anna, Verstraete Laurence, Croonenborghs Tomas-Marijn, Politis Constantinus, Swennen Gwen R J
Division of Maxillofacial Surgery, Department of Surgery, AZ Sint-Jan, Ruddershove 10, 8000 Bruges, Belgium.
Maxillofacial Surgery Unit, Department of Head and Neck Surgery, Craniomaxillofacial Center for Children and Young Adults, Regional Specialized Children's Hospital, ul. Zolnierska 18A, 10-561 Olsztyn, Poland.
J Imaging. 2024 May 14;10(5):119. doi: 10.3390/jimaging10050119.
Three-dimensional soft tissue simulation has become a popular tool in the process of virtual orthognathic surgery planning and patient-surgeon communication. To apply 3D soft tissue simulation software in routine clinical practice, both qualitative and quantitative validation of its accuracy are required. The objective of this study was to systematically review the literature on the accuracy of 3D soft tissue simulation in orthognathic surgery. The Web of Science, PubMed, Cochrane, and Embase databases were consulted for the literature search. The systematic review (SR) was conducted according to the PRISMA statement, and 40 articles fulfilled the inclusion and exclusion criteria. The Quadas-2 tool was used for the risk of bias assessment for selected studies. A mean error varying from 0.27 mm to 2.9 mm for 3D soft tissue simulations for the whole face was reported. In the studies evaluating 3D soft tissue simulation accuracy after a Le Fort I osteotomy only, the upper lip and paranasal regions were reported to have the largest error, while after an isolated bilateral sagittal split osteotomy, the largest error was reported for the lower lip and chin regions. In the studies evaluating simulation after bimaxillary osteotomy with or without genioplasty, the highest inaccuracy was reported at the level of the lips, predominantly the lower lip, chin, and, sometimes, the paranasal regions. Due to the variability in the study designs and analysis methods, a direct comparison was not possible. Therefore, based on the results of this SR, guidelines to systematize the workflow for evaluating the accuracy of 3D soft tissue simulations in orthognathic surgery in future studies are proposed.
三维软组织模拟已成为虚拟正颌手术规划及医患沟通流程中一种常用工具。要将三维软组织模拟软件应用于常规临床实践，需要对其准确性进行定性和定量验证。本研究的目的是系统回顾有关正颌手术中三维软组织模拟准确性的文献。通过检索科学网、PubMed、考克兰图书馆和Embase数据库获取文献。根据PRISMA声明进行系统评价（SR），40篇文章符合纳入和排除标准。使用Quadas - 2工具对所选研究进行偏倚风险评估。据报道，全脸三维软组织模拟的平均误差在0.27毫米至2.9毫米之间。在仅评估Le Fort I截骨术后三维软组织模拟准确性的研究中，上唇和鼻旁区域的误差最大，而在孤立的双侧矢状劈开截骨术后，下唇和下巴区域的误差最大。在评估双颌截骨术（有或无颏成形术）后模拟情况的研究中，嘴唇部位的误差最大，主要是下唇、下巴，有时还有鼻旁区域。由于研究设计和分析方法存在差异，无法进行直接比较。因此，基于本系统评价的结果，提出了在未来研究中系统化评估正颌手术中三维软组织模拟准确性工作流程的指南。
