Abstract
BackgroundThe elaboration of a precise pre-surgical plan is essential during surgical treatment of dentofacial deformities. The aim of this study was to evaluate the accuracy of computer-aided simulation compared with the actual surgical outcome, following orthognathic surgery reported in clinical trials.MethodsOur search was performed in PubMed, EMBASE, Cochrane Library and SciELO for articles published in the last decade. A total of 392 articles identified were assessed independently and in a blinded manner using eligibility criteria, out of which only twelve articles were selected for inclusion in our research. Data were presented using intra-class correlation coefficient, and linear and angular differences in three planes.ResultsThe comparison of the accuracy analyses of the examined method has shown an average translation (< 2 mm) in the maxilla and also in the mandible (in three planes). The accuracy values for pitch, yaw, and roll (°) were (< 2.75, < 1.7 and < 1.1) for the maxilla, respectively, and (< 2.75, < 1.8, < 1.1) for the mandible. Cone-beam computed tomography (CBCT) with intra-oral scans of the dental casts is the most used imaging protocols for virtual orthognathic planning. Furthermore, calculation of the linear and angular differences between the virtual plan and postoperative outcomes was the most frequented method used for accuracy assessment (10 out of 12 studies) and a difference less than 2 mm/° was considered acceptable and accurate.When comparing this technique with the classical planning, virtual planning appears to be more accurate, especially in terms of frontal symmetry.ConclusionVirtual planning seems to be an accurate and reproducible method for orthognathic treatment planning. However, more clinical trials are needed to clearly determine the accuracy and validation of the virtual planning in orthognathic surgery.
Highlights
The elaboration of a precise pre-surgical plan is essential during surgical treatment of dentofacial deformities
These variations we summarized in (Table 3)
The actual accuracy values are presented in detail in Additional file 1 (Table S1)
Summary
The elaboration of a precise pre-surgical plan is essential during surgical treatment of dentofacial deformities. Two-dimensional (2D) radiographs and manual model surgery are essential parts of the preoperative planning for orthognathic surgery This approach has its limitations, especially in the case of patients with major facial deformity or asymmetry [1], as 2D cephalometric images cannot provide full information about the 3D structures. Any variation between the plan and the plaster model surgery could lead to a poorly fabricated wafer, which in turn could lead to unexpected (and often undesirable) results, regardless of how skillfully and carefully the surgery is performed [3]. These examples illustrate that the elaboration of a precise pre-surgical plan is of utmost importance when it comes to correcting dentofacial deformities
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