EVALUATION OF THE USE OF BONE-BORNE CAD/CAM SURGICAL GUIDES IN ORTHOGNATHIC SURGERY CASES REQUIRING LE FORT I OSTEOTOMY

Abstract

Background: Dentofacial deformities have many negative consequences in the form and function of head and neck region. It is estimated that in about 19% of orthodontic patients, orthognathic surgery is required along with the orthodontic procedure. The introduction of CAD/CAM technology in orthognathic surgery planning has facilitated the procedure and allowed for more predicted results. Aim of this study: The aim of the present study is to propose a new design of the intermediate stent that relates the mobilized maxilla to a fixed anatomical landmark in the skull which would allow for more accurate positioning of the maxilla during orthognathic surgery. Materials and methods: This study was conducted on sixteen patients who have been undergone Le Fort I osteotomy procedure. Eight of them were treated via a conventional stent while the other eight patients via a CAD/CAM bone-borne stent. Postoperative patient evaluation was performed by comparing the predicted and actual position postoperatively. This was done via 3D reconstruction CT scans. Results: Sixteen patients were recruited for the study (n=16), 5 males and 11 females, and were randomly allocated into two groups. Age ranged from 16 to 42 years with a mean of 24.31 ± 7.49. Pain evaluated by VAS was also found statistically insignificant between both groups using Independent samples t-test and Mann-Whitney U test (p < 0.05). Error of superimposition was found to be statistically significant between control group (0.317±0.22) and study group (0.870±0.23) using independent samples t-test (p < 0.05). Conclusion: The new intermediate splint design needs further modifications and refinement.