Accuracy of midface advancement using patient-specific surgical guides and pre-bent plates versus conventional interocclusal wafers and conventional plate fixation in quadrangular Le Forte II osteotomy. A randomised controlled trial

Abstract

The aim of this study was to assess the accuracy of quadrangular Le Fort II osteotomy and midface advancement utilising digitally fabricated surgical guides with pre-bent plates compared with conventional interocclusal wafers. Twenty patients with midface deficiency were allocated randomly to two groups: patient-specific surgical guides and pre-bent titanium miniplates were utilised in the study group, while conventional interocclusal wafers with intraoperatively adapted titanium miniplates were utilised in the control group. The accuracy of virtual planning was assessed in both groups using computed tomography (CT). Both groups showed accurate transfer of the plan, but the computer-guided group showed significantly greater accuracy and a shorter surgical time than the conventional group. The use of patient-specific surgical guides and pre-bent plates represents a promising computer-guided approach especially for inexperienced surgeons. Nevertheless, a major limitation is increased overall cost compared with the conventional approach.