Lee Yoon-Jo, Oh Ji-Hyeon, Kim Seong-Gon
Department of Oral and Maxillofacial Surgery, College of Dentistry, Gangneung-Wonju National University, Gangneung, 25457, Republic of Korea.
Maxillofac Plast Reconstr Surg. 2024 Nov 14;46(1):39. doi: 10.1186/s40902-024-00449-2.
The shift from traditional two-dimensional (2D) planning to three-dimensional (3D) virtual surgical planning (VSP) has revolutionized orthognathic surgery, offering new levels of precision and control. VSP, combined with computer-aided design/computer-aided manufacturing (CAD/CAM) technology, enables the creation of patient-specific surgical guides and implants that translate preoperative plans into more precise surgical outcomes. This review examines the comparative accuracy and operative efficiency of VSP, especially when used with custom surgical guides, against conventional 2D planning in orthognathic surgery.
The study systematically reviewed and analyzed published literature comparing the accuracy and operative time between VSP and conventional planning methods. The meta-analysis included clinical trials, controlled trials, and observational studies on patients undergoing orthognathic surgery, focusing on the degree of alignment between planned and postoperative bone positions and total surgery time. Results indicate that VSP consistently reduces discrepancies between planned and actual surgical outcomes, particularly when integrated with custom surgical guides. Additionally, while VSP demonstrated potential time-saving advantages over conventional planning, these differences were not statistically significant across studies, likely due to high variability among study protocols and designs.
VSP with custom surgical guides enhances surgical accuracy in orthognathic procedures, marking a significant advancement over traditional methods. However, the reduction in operative time was not conclusively significant, underscoring the need for further studies to evaluate time efficiency. These findings emphasize VSP's role in improving surgical precision, which holds substantial implications for future orthognathic surgical practices.
从传统的二维(2D)规划转向三维(3D)虚拟手术规划(VSP)彻底改变了正颌外科手术,提供了更高水平的精度和控制。VSP与计算机辅助设计/计算机辅助制造(CAD/CAM)技术相结合,能够创建针对患者的手术导板和植入物,将术前规划转化为更精确的手术结果。本综述探讨了VSP,尤其是与定制手术导板一起使用时,相对于正颌外科手术中传统2D规划的比较准确性和手术效率。
该研究系统地回顾和分析了已发表的文献,比较了VSP与传统规划方法之间的准确性和手术时间。荟萃分析包括对接受正颌外科手术患者的临床试验、对照试验和观察性研究,重点关注计划和术后骨位置之间的对齐程度以及总手术时间。结果表明,VSP持续减少了计划手术结果与实际手术结果之间的差异,特别是在与定制手术导板结合使用时。此外,虽然VSP显示出比传统规划潜在的节省时间的优势,但这些差异在各项研究中没有统计学意义,可能是由于研究方案和设计的高度变异性。
使用定制手术导板的VSP提高了正颌手术的准确性,标志着相对于传统方法的重大进步。然而,手术时间的减少并没有确凿的显著性,这突出了需要进一步研究来评估时间效率。这些发现强调了VSP在提高手术精度方面的作用,这对未来的正颌手术实践具有重要意义。