The application of digital surgical template in bimaxillary orthognathic surgery / 中华整形外科杂志

ABSTRACT

Objective@#To investigate the feasibility and accuracy using digital surgical guide to position the jaws in bimaxillary orthognathic surgery.@*Methods@#16 patients with dento-maxillofacial deformity were included from January to December 2018 in Nanjing Stomatological Hospital. There were 10 males and 6 females, all of which were skeletal Ⅲ deformity. The mean age was 21.3 years old (16 to 28 years). They were divided into digital guide (group A) and traditional model surgery (group B) according to the treatment sequence. All patients underwent both Lefort Ⅰ osteotomy and bilateral ascending sagittal split. Virtual surgery was performed and digital three-dimensional surgical template was printed before surgery in group A. During the operation, digital surgical templates were used to position maxilla and mandible. The accuracy was evaluated by generating color distribution map of deviation grade, which was imaging fusion of virtual surgical jaw position and actual surgical jaw position to measure the deviation distance of each marker point one week after surgery. The deviations between the preoperative design and the actual operation were compared with the t-test respectively in group A and group B, and the independent sample t test was chosen to compared the accuracy of reduction between the two groups in sagittal, horizontal, and vertical directions.@*Results@#All 16 patients had primary healing. The maximum deviation of the patients in group A was at U6. The deviation direction was vertical, and the deviation distance was (1.67±0.32) mm. In group A, the deviation distances of all marker points in the sagittal, horizontal and vertical directions were (0.55±0.26) mm (t=2.985, P=0.205), (0.62±0.20) mm (t=2.672, P=0.193) and (1.07±0.62) mm (t=5.122, P=0.823), respectively. The result in group B was (0.63±0.28) mm(t=3.397, P=0.307), (0.71±0.42) mm (t=4.438, P=0.541) and (1.82±0.36) mm (t=1.115, P=0.021) in these directions. There was no significant difference between two groups in the sagittal (t=4.704, P=0.763) and lateral (t=4.008, P=0.615) directions, and the difference in the vertical (t=1.432, P=0.037) direction was statistically significant.@*Conclusions@#The digital guides were feasible to position jaws accurately in orthognathic surgery.