Varazzani Andrea, Tognin Laura, Corre Pierre, Bouletreau Pierre, Perrin Jean-Philippe, Menapace Giorgia, Bergonzani Michela, Pedrazzi Giuseppe, Anghinoni Marilena, Poli Tito
Maxillo-Facial Surgery Unit, Head and Neck Department, University-Hospital of Parma, Gramsci Road 14, 42126, Parma, Italy; Maxillo-Facial Surgery, Facial Plastic Surgery, Stomatology and Oral Surgery, Hospices Civils de Lyon, Lyon-Sud Hospital - Claude-Bernard Lyon 1 University, 165 Chemin du Grand-Revoyet, Pierre-Bénite 69310, France.
Maxillo-Facial Surgery Unit, Head and Neck Department, University-Hospital of Parma, Gramsci Road 14, 42126, Parma, Italy.
J Stomatol Oral Maxillofac Surg. 2025 Feb;126(1):102025. doi: 10.1016/j.jormas.2024.102025. Epub 2024 Sep 1.
The development of 3D computer-assisted technologies over the past years has led to vast improvements in orthognathic surgery. The aim of the present study was to evaluate differences in maxillary position between 3D virtual surgical planning (VSP) and surgical results.
We assessed data from 25 patients who underwent bimaxillary non-segmented orthognathic surgery with 3D VSP. Each patient underwent a postoperative CT scan within 40 days after surgery. We compared the STL (Standard Triangulation Language) file from the VSP with that obtained from the postoperative CT.
According to our comparative analysis, the postoperative and VSP 3D models did not statistically differ. The Lin concordance correlation coefficient was always >0.95 for each landmark, but in 21 patients (84 % of the sample) we identified at least one point with a difference of more than 1.5 mm between the postoperative and VSP 3D model on at least one axis. The most frequently observed differences corresponded to sagittal translation and pitch rotation.
An intraoperative clinical and aesthetic evaluation of the consequences of bone movements on patient face is strongly recommended, also when we use VSP because we may have clinically significant differences from the planning.
过去几年3D计算机辅助技术的发展极大地推动了正颌外科手术的进步。本研究旨在评估三维虚拟手术规划（VSP）与手术结果在上颌位置上的差异。
我们评估了25例行双颌非分段正颌手术并采用3D-VSP的患者的数据。每位患者在术后40天内接受了CT扫描。我们将VSP的STL（标准三角测量语言）文件与术后CT获得的文件进行了比较。
根据我们的对比分析，术后3D模型与VSP 3D模型在统计学上无差异。每个标志点的林一致性相关系数始终>0.95，但在21例患者（占样本的84%）中，我们发现至少有一个点在术后3D模型和VSP 3D模型之间至少在一个轴向上的差异超过1.5毫米。最常观察到的差异对应于矢状平移和俯仰旋转。
强烈建议在术中对骨移动对患者面部的影响进行临床和美学评估，即使在使用VSP时也是如此，因为我们可能会在临床上与规划产生显著差异。
