Abstract
Orthognathic surgical planning compromises three clinical needs: occlusal balancing, symmetry, and harmony, which may result in multiple outcomes. Facial symmetry is the ultimate goal for patients and practitioners. Pure virtual planning and mixed reality planning were two innovative technologies in clinical practices compared to conventional model surgery used for decades. We proposed quantitative asymmetry assessment methods in both mandibular contour (in 2D) and a midface and mandible relationship in 3D. A computerized optimal symmetry plane, being the median plane, was applied in both planning methods. In the 3D asymmetry assessment between two planning methods, the deviation angle and deviation distance between midface and mandible were within 2° and 1.5 mm, respectively. There was no significant difference, except the symmetry index of the anterior deviation angle between the virtual and mixed reality planning in the 3D asymmetry assessment. In the mandible contour assessment, there was no significant difference between the virtual and mixed reality planning in asymmetry assessment in the frontal and frontal downward inclined views. Quantitative outcomes in 3D asymmetry indices showed that mixed reality planning was slightly more symmetric than virtual planning, with the opposite in 2D contouring.
Highlights
Orthognathic surgery is used to reposition the basal bone in the framework of maxillamandibular deformities [1], providing aesthetic and functional results [2]
Quantitative outcomes of 3D asymmetry indices showed that navigational planning system (NPS) was slightly more symmetric than virtual surgical planning (VSP)
Except for the frontal deviation angle between the midface and mandible optimal symmetry plane (OSP), there was no significant difference between VSP and NPS planning in the 3D asymmetry assessment
Summary
Orthognathic surgery is used to reposition the basal bone in the framework of maxillamandibular deformities [1], providing aesthetic and functional results [2]. To compare the asymmetry status of virtual and mixed reality planning techniques, we invoked the mandibular contour evaluation method to quantify asymmetry. In both types of planning, the same functions in computer simulations were applied, such as osteotomy, 3D movements, occlusal detection, adjustment, alignment, and cephalometric measurements in real-time. Both types of planning invoked OSP as the respective median planes for the midface and mandible. Meta-analysis using the Wilcoxon signed-rank test was utilized to explore whether there was a significant difference in asymmetry outcomes between these two types of surgical planning
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