Surgical Treatment Selection in Adult Class III Patients With Maxillary Transverse Deficiency.

The purpose of this study was to investigate the frequency of three commonly used treatments for skeletal class III malocclusion with maxillary transverse deficiency (MTD) (SCM) patients in East Asian, to find a quantitative method for precise discrepancy evaluation, and to find other potential indicators for treatment selection. A total of 239 adult SCM patients were divided into3 groups according to treatments.Dentofacial features were measured and the initial skeletal discrepancy was evaluated with computer-aided surgical simulation (CASS). Relationship between the degree of skeletal transverse discrepancy (STD) and other dentofacial features were analyzed by Spearman's rank correlation. The STD in East Asian could be quantitatively grouped as: mild (<4 mm), moderate (4-8 mm), and severe (>8 mm). Most patients (81%) could be diagnosed with mild STD, and were treated without surgical expansion. The upper first molars inclination, the required relative movement and the required maxillary movement were correlated to the degree of STD. The conventional orthodontic and orthognathic treatment without surgical expansion is the most frequent choice for East Asian SCM adults. CASS facilitated analysis is useful in an accurate MTD evaluation. Some dentofacial features were closely correlated to STD, and thus were helpful for the treatment selection.

Virtual Surgical Planning Assisted Management for Three-Dimensional Dentomaxillofacial Deformities.

OBJECTIVE: Treatment of 3-dimensional dentomaxillofacial deformities remains a significant clinical challenge. This retrospective study aims to present the modalities of management for complex 3-dimensional dentomaxillofacial deformities with the assistance of virtual surgical planning (VSP) and 3-dimensional printed navigation templates. STUDY DESIGN: Ten patients diagnosed with complex 3-dimensional dentomaxillofacial deformities received treatment of combined orthodontics and orthognathic surgery. Various surgical techniques as well as bone graft and distraction osteogenesis were used under the guidance of VSP and 3-dimensional printed navigation templates according to the characteristics of each patient. Follow-up included clinical examination and studies of spiral computed tomography preoperatively and for an average of 12 months postoperatively. RESULT: The clinical outcomes of patients showed that VSP was successfully transferred to actual surgery in all the 10 patients. Three-dimensional dentomaxillofacial deformities were corrected significantly. Satisfactory profiles and occlusion were achieved. CONCLUSION: The management of 3-dimensional dentomaxillofacial deformities required comprehensive consideration and detailed surgical planning. Virtual surgical planning serves as a reliable assistance in the management of 3-dimensional dentomaxillofacial deformities.