Refining Post-Orthognathic Surgery Facial Contour with Computer-Designed/Computer-Manufactured Alloplastic Implants.

Abstract

Le Fort I maxillary osteotomies and sagittal split mandibular osteotomies are performed to correct significant dentofacial deformities. The multidimensional skeletal movements, particularly those of large magnitude, may result in contour irregularities and facial imbalances. Three-dimensional images were reconstructed from computed tomographic scans in patients unhappy with their appearances after Le Fort I advancement and/or bilateral sagittal split osteotomies. The data from these scans were used to produce alloplastic implants using computer-aided design/computer-aided manufacturing for surgical correction of contour irregularities and imbalances. These implants were surgically placed through intraoral and submental incisions and fixed using titanium screws. A total of 21 patients underwent implant placement with implants produced using computer-design/computer manufacturing. One patient required removal of implants secondary to infection. All other patients were satisfied with their result. The use and surgical placement of implants produced by means of computer-aided design/computer-aided manufacturing has been shown to be effective in refining appearance in 21 patients over a 7-year period with minimal morbidity. Therapeutic, IV.