The Accuracy of Jaws Repositioning in Bimaxillary Orthognathic Surgery with Traditional Surgical Planning Compared to Digital Surgical Planning in Skeletal Class III Patients: A Retrospective Observational Study.

Martina Barone,Giovanni Bruno,Ugo Baciliero,Alberto De Stefani,Antonio Gracco

doi:10.3390/jcm9061840

Martina Barone, Giovanni Bruno + Show 3 more

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https://doi.org/10.3390/jcm9061840

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Abstract

Background: Technological progress has led to the transition to digital methods to perform surgical planning and to obtain surgical splints with CAD/CAM technologies. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. Methods: This study included 60 skeletal class III patients divided into two groups based on the method used to perform surgical planning: traditional (T, n = 30) and digital (D, n = 30). For each patient, a 2D presurgical Visual Treatment Objective (VTO) was prepared and the outcome of the surgery was compared with that planned by using determined cephalometric measurements (ANB, SNA, SNB, Ar-Go-Me, S-Ar-Go). Statistical analysis showed that the measurements planned and those obtained after surgery were equivalent in Group D. For Group T, the analysis showed equivalence only for one of the considered measurements (ANB). By comparing the results of the two groups, Group D presented a lower level of error than Group T. Conclusions: Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol.

Highlights

Skeletal class III malocclusions are discrepancies observable in the anteroposterior plane, characterized by a disharmonic relationship between cranial bone structures and the maxillofacial complex, or between the maxillary bones only, resulting in a more mesial position of the mandible compared to the maxilla [1,2,3]
In non-growing skeletal class III patients that cannot be adequately treated only with an orthodontic therapy, the orthodontic–surgical treatment is the therapeutic approach of choice
The cephalometric measurement for which the traditional surgical planning showed less equivalence of the result is the Ar-Go-Me angle (p = 0.78): an absolute difference higher than 2◦ of the planned measurement compared to that obtained appeared in 33% of the cases

Summary

Introduction

Skeletal class III malocclusions are discrepancies observable in the anteroposterior plane, characterized by a disharmonic relationship between cranial bone structures and the maxillofacial complex, or between the maxillary bones only, resulting in a more mesial position of the mandible compared to the maxilla [1,2,3]. This type of skeletal malocclusion is the result of the deficient development of the maxilla, an excessive development, and/or prognathism of the mandible, or most often by a combination of these skeletal problems [1,3,4,5]. The present study aimed to compare the accuracy of jaw repositioning in bimaxillary orthognathic surgery using traditional and digital surgical planning in skeletal class III patients. Conclusions: Digital surgical planning performed significantly better in terms of accuracy of jaw repositioning than the traditional protocol

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