Abstract
The aim of this study was to investigate an accuracy of modified CAD/CAM generated wafers for orthognathic surgery. A total of 20 patients who had undergone bimaxillary orthognathic surgery were included and divided into two groups: A conventional CAD/CAM generated intermediate wafer and a modified CAD/CAM generated intermediate wafer. A series of CT images were taken to compare the virtual simulations with the actual postoperative outcomes(1 month after surgery). In conventional group, the mean difference of maxillary position between virtual simulation models and postoperative results was 0.78mm and overall average error within 1mm was observed in 66.4% of the repositioned maxilla. In modified group, the mean difference was 0.77mm and overall average error within 1mm was observed in 68.3%. There were no significant statistic differences between two groups in maxillary position. This study suggests that the CAD/CAM generated wafer provides excellent accuracy. The modified CAD/CAM wafer was only comparable to conventional design in accuracy and it cannot guarantee the superior precision. However, the modified design could be beneficial in cases with unstable condylar position or for inexperienced surgeons.
Highlights
Diagnosing and treatment planning for corrective jaw surgery based on 2-dimensional(2D) cephalometric radiographs have been successful for a few decades.[1]
Patients were divided into two groups according to the type of CAD/CAM surgical wafers used: conventional group(n = 10), conventional occlusal based wafer; modified group(n = 10), modified surgical guide.(Fig 1) There was no difference in severity of deformity between two groups
Kwon et al reported that the surgical accuracy of maxillary positioning with CAD/CAM wafer was comparable to conventional articulator generated wafer.[17]
Summary
Diagnosing and treatment planning for corrective jaw surgery based on 2-dimensional(2D) cephalometric radiographs have been successful for a few decades.[1] ,there are many sources for errors during the preoperative treatment planning phases and intraoperative repositioning of bony segments to a planned position in cases of severe dentofacial deformity requiring complex maxillomandibular movement. The importance of 3D virtual diagnosis and planning was highlighted to overcome the limitations of the traditional method.[2,3,4] By virtue of computed tomography(CT) imaging and 3D printing technique, 3D virtual planning with fully digitized patients’ data have been studied and the surgical wafer can be fabricated from these data.[3,5,6] computer-aided.
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