scholarly journals The Accuracy of Jaws Repositioning in Bimaxillary Orthognathic Surgery with Traditional Surgical Planning Compared to Digital Surgical Planning in Skeletal Class III Patients: A Retrospective Observational Study

2020 ◽  
Vol 9 (6) ◽  
pp. 1840
Author(s):  
Martina Barone ◽  
Alberto De Stefani ◽  
Ugo Baciliero ◽  
Giovanni Bruno ◽  
Antonio Gracco
Keyword(s):  
Orthognathic Surgery ◽  
Surgical Planning ◽  
Class Iii ◽  
Skeletal Class ◽  
Bimaxillary Orthognathic Surgery ◽  
Cad Cam ◽  
Treatment Objective ◽  
Digital Methods ◽  
Cephalometric Measurements ◽  
Group D

Background: Technological progress has led to the transition to digital methods to perform surgical planning and to obtain surgical splints with CAD/CAM technologies. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. Methods: This study included 60 skeletal class III patients divided into two groups based on the method used to perform surgical planning: traditional (T, n = 30) and digital (D, n = 30). For each patient, a 2D presurgical Visual Treatment Objective (VTO) was prepared and the outcome of the surgery was compared with that planned by using determined cephalometric measurements (ANB, SNA, SNB, Ar-Go-Me, S-Ar-Go). Statistical analysis showed that the measurements planned and those obtained after surgery were equivalent in Group D. For Group T, the analysis showed equivalence only for one of the considered measurements (ANB). By comparing the results of the two groups, Group D presented a lower level of error than Group T. Conclusions: Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol.

scholarly journals Computer-Aided Planning in Orthognathic Surgery: A Comparative Study with the Establishment of Burstone Analysis-Derived 3D Norms

2019 ◽  
Vol 8 (12) ◽  
pp. 2106 ◽  
Author(s):  
Cheng-Ting Ho ◽  
Rafael Denadai ◽  
Hsin-Chih Lai ◽  
Lun-Jou Lo ◽  
Hsiu-Hsia Lin
Keyword(s):  
Orthognathic Surgery ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Class Iii ◽  
Facial Soft Tissue ◽  
Skeletal Class ◽  
Nasolabial Angle ◽  
Normal Occlusion ◽  
Computer Aided ◽  
Cephalometric Measurements

Three-dimensional (3D) computer-aided simulation has revolutionized orthognathic surgery treatment, but scarce 3D cephalometric norms have been defined to date. The purposes of this study were to (1) establish a normative database of 3D Burstone cephalometric measurements for adult male and female Chinese in Taiwan, (2) compare this 3D norm dataset with the two-dimensional (2D) Burstone norms from Caucasian and Singaporean Chinese populations, and (3) apply these 3D norms to assess the outcome of a computer-aided simulation of orthognathic surgery. Three-dimensional Burstone cephalometric analysis was performed on 3D digital craniofacial image models generated from cone-beam computed tomography datasets of 60 adult Taiwanese Chinese individuals with normal occlusion and balanced facial profile. Three-dimensional Burstone analysis was performed on 3D image datasets from patients with skeletal Class III pattern (n = 30) with prior computer-aided simulation. Three-dimensional Burstone cephalometric measurements showed that Taiwanese Chinese males had significantly (p < 0.05) larger anterior and posterior facial heights, maxillary length, and mandibular ramus height than females, with no significant (p > 0.05) difference for facial soft-tissue parameters. The 3D norm dataset revealed Taiwanese Chinese-specific facial characteristics, with Taiwanese presenting (p < 0.05) a more convex profile, protrusive maxillary apical bases, protruding mandible, protruding upper and lower lips, and a shorter maxillary length and lower facial height than Caucasians. Taiwanese had significantly (p < 0.05) larger maxillary projection, vertical height ratio, lower face throat angle, nasolabial angle, and upper lip protrusion than Singaporean Chinese. No significant (p > 0.05) difference was observed between 3D norms and computer-aided simulation-derived 3D patient images for horizontal skeletal, vertical skeletal, and dental measurements, with the exception of two dental parameters (p < 0.05). This study contributes to literature by providing gender- and ethnic-specific 3D Burstone cephalometric norms, which can assist in the multidisciplinary-based delivery of orthodontic surgical care for Taiwanese Chinese individuals worldwide, including orthodontic management, computer-assisted simulation, and outcome assessment.

scholarly journals A New Approach to Set the Absolute Midsagittal Plane of the Mandible Using a Similarity Index in Skeletal Class III Patients with Facial Asymmetry

2020 ◽  
Vol 10 (23) ◽  
pp. 8550
Author(s):  
Woo-Jin Han ◽  
Jae Joon Hwang ◽  
Yun-Hoa Jung ◽  
Bong-Hae Cho ◽  
Kee-Joon Lee ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Similarity Index ◽  
Facial Asymmetry ◽  
Class Iii ◽  
Midsagittal Plane ◽  
New Approach ◽  
Skeletal Class ◽  
Computed Tomography Images ◽  
Bimaxillary Orthognathic Surgery ◽  
Anterior Segments

This study sought to test the feasibility of a newly developed plane called computed modified absolute mandibular midsagittal plane (cmAMP) based on the similarity index (SI) for evaluating the stereoscopical symmetry of the mandible by comparison with other proposed midsagittal planes. This study involved 29 adult patients (15 men, 14 women; average age, 23.1 ± 6.9 years) with skeletal Class III facial asymmetry who underwent bimaxillary orthognathic surgery. Using cone-beam computed tomography images taken before and 1 year after surgery, cmAMP with the highest SI value between the two anterior segments of the hemi-mandible was set by a computer algorithm. Results show that the SI using cmAMP had the highest value (0.83 ± 0.04) before surgery compared to the other midsagittal planes, and was not significantly different from the SI (0.80 ± 0.05) using a facial midsagittal plane (MSP) after surgery. The distance (1.15 ± 0.74 mm) and angle (2.02 ± 0.82°) between MSP and cmAMP after surgery were significantly smaller than those between MSP and other midsagittal planes. In conclusion, the cmAMP plane best matches the two anterior segments of hemi-mandible symmetrically and is the closest to MSP after orthognathic surgery in skeletal Class III patients with facial asymmetry.

scholarly journals Postsurgical Stability of Temporomandibular Joint of Skeletal Class III Patients Treated with 2-Jaw Orthognathic Surgery via Computer-Aided Three-Dimensional Simulation and Navigation in Orthognathic Surgery (CASNOS)

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Ling-Chun Wang ◽  
Yi-Hao Lee ◽  
Chi-Yu Tsai ◽  
Te-Ju Wu ◽  
Ya-Ying Teng ◽  
...  
Keyword(s):  
Orthognathic Surgery ◽  
Three Dimensional ◽  
Class Iii ◽  
Skeletal Class ◽  
Computer Aided ◽  
Before And After ◽  
Bimaxillary Orthognathic Surgery ◽  
The Mean ◽  
Dimensional Simulation ◽  
The Right

Objective. The aim of this study is to clarify the postsurgical stability of temporomandibular joints in skeletal class III patients treated with 2-jaw orthognathic surgery which was performed utilizing computer-aided three-dimensional simulation and navigation in orthognathic surgery (CASNOS) protocol. Materials and Methods. 23 consecutive nongrowing skeletal class III patients with mandibular prognathism associated with maxillary retrognathism treated with 2-jaw orthognathic surgery between 2018 and 2019 were enrolled in this study. The surgery was planned according to the standardized protocol of CASNOS (computer-aided three-dimensional simulation and navigation in orthognathic surgery). Computed tomography (CT) scans were performed in all patients 3 weeks presurgically and 6 months postsurgically. ITKSNAP and 3D Slicer software were used to reconstruct three-dimensional facial skeletal images, to carry out image segmentation, and to superimpose and quantify the TMJ position changes before and after surgery. Amount of displacement of the most medial and lateral points of the condyles and the change of intercondylar angles were measured to evaluate the postsurgical stability of TMJ. Results. A total amount of 23 skeletal class III patients female : male = 12 : 11 with age ranged from 20.3 to 33.5 years (mean: 24.39 ± 4.8   years   old ) underwent Le Fort I maxillary advancement and BSSO setback of the mandible. The surgical outcome revealed the satisfactory correction of their skeletal deformities. The mean displacement of the right most lateral condylar point (RL-RL ′ ) was 1.04 ± 0.42   mm and the mean displacement of the left most lateral condylar point (LL-LL ′ ) was 1.19 ± 0.41   mm . The mean displacement of the right most medial condylar point (RM-RM ′ ) was 1.03 ± 0.39   mm and the left most medial condylar point (LM-LM ′ ) was 0.96 ± 0.39   mm . The mean intercondylar angle was 161.61 ± 5.08 ° presurgically and 159.28 ± 4.92 ° postsurgically. Conclusion. The postsurgical position of TM joint condyles in our study only presented a mild change with all the landmark displacement within a range of 1.2 mm. This indicates the bimaxillary orthognathic surgery via 3D CASNOS protocol can achieve a desired and stable result of TMJ position in treating skeletal class III adult patients with retrognathic maxilla and prognathic mandible.

scholarly journals Surgical treatment of a skeletal Class III patient using customized brackets based on the CAD/CAM virtual orthodontic system

2021 ◽  
Author(s):  
Eun-Hack Andrew Choi ◽  
Jin-Ho Park ◽  
Tselmuun Erdenebat ◽  
Chung-Ju Hwang ◽  
Jung-Yul Cha
Keyword(s):  
Computer Aided Design ◽  
Orthognathic Surgery ◽  
Orthodontic Treatment ◽  
Treatment Time ◽  
Three Dimensional ◽  
Class Iii ◽  
Efficient Treatment ◽  
Skeletal Class ◽  
Computer Aided ◽  
Cad Cam

ABSTRACT The computer-aided design/computer-aided manufacturing (CAD/CAM) virtual orthodontic system produces customized brackets, indirect bonding jigs, and archwires based on a three-dimensional virtual setup. In surgical cases, this system helps to visualize the final occlusion during diagnosis and to efficiently plan individualized presurgical orthodontic treatments. A 20-year-old female patient with a skeletal Class III malocclusion, maxillary protrusion, and lip protrusion was successfully treated with orthognathic surgery and orthodontic treatment with maxillary first premolar extractions. The CAD/CAM system was applied for efficient treatment, with a total active treatment time of 16 months. In this case report, the applicability of the CAD/CAM virtual orthodontic system for orthognathic surgery cases is demonstrated. Suggestions are also made to overcome the limitations and to maximize the advantages of this system during orthodontic treatment of patients undergoing orthognathic surgery.

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