Application of digital guide plate based on drill-hole sharing in oral and maxillofacial surgery.

Abstract

This study aimed to investigate the application of digital guide plate based on the drill-hole sharing concept in orthognathic surgery and mandibular reconstruction. Sixteen patients with maxillofacial deformity requiring orthognathic surgery and 10 patients requiring mandibular reconstruction were selected as the research objects. Patients with maxillofacial deformity were scanned by computed tomography (CT), gypsum mold of the maxilla and mandibular arch were scanned using a laser surface scanner, and the fibula or iliac bone of the patients who needed mandibular reconstruction were scanned by CT to create a 3D model. The osteotomy and repositioning guides based on the drill-hole sharing concept were manufactured by digital technology. The guide plate was used to guide osteotomy and reposition the bone segment. Postoperative CT scan was performed. The displacement error of the bone segment was compared between the preoperative virtual surgery and the actual surgery to evaluate the accuracy of the guide plate, by measuring the distance between the landmarks and three reference planes and the distance between the two landmarks. The wounds healed well in all patients, and no serious complications were observed. The maximum mean values of LeFort Ⅰ osteotomy, genioplasty, fibular reconstruction, and iliac reconstruction were 0.84, 0.64, 1.27, and 1.18 mm, respectively; these values were acceptable by clinical standards. The digital guide plate based on the drill-hole sharing concept has high accuracy and clinical application value in orthognathic surgery and mandibular reconstruction.