Abstract
BackgroundSurgical guiding templates provided a reliable way to transfer the simulation to the actual operation. However, there was no template designed for anterior segmental osteotomy so far. The study aimed to introduce and evaluate a set of 3D rapid prototyping surgical templates used in anterior segmental osteotomy.Material and MethodsFrom August 2015 to August 2017, 17 patients with bimaxillary protrusions were recruited and occlusal-based multi-sectional templates were applied in the surgeries. The cephalometric analysis and 3D superimposition were performed to evaluate the differences between the simulations and actual post-operative outcomes. The patients were followed-up for 12 months to evaluate the incidence rate of complications and relapse.ResultsBimaxillary protrusion was corrected in all patients with no complication. In radiographic evaluations, there was no statistically significant difference between the actual operations and the computer-aided 3D simulations (p >0.05, the mean linear and angular differences were less than 1.32mm and 1.72° consequently, and 3D superimposition difference was less than 1.4mm). The Pearson intraclass correlation coefficient reliabilities were high (0.897), and the correlations were highly significant (P< 0.001).ConclusionsThe 3D printed surgical template designed in this study can safely and accurately transfer the computer-aided 3D simulation into real practice. Key words:CAD/CAM; anterior segmental osteotomy; surgical guiding templates; bimaxillary protrusion; virtual surgery simulation.
Highlights
Bimaxillary protrusion (BP) is a common type of dento-maxillofacial deformities, predominantly in African and Asian adults [1,2] The main clinical manifestations of BP are protrusive and proclined incisors, which are usually combined with lip incompetence, gummy smile, mentalis strain, receding chin, and anterior open bite
The orthodontic treatments can make a good effect for patients with proclined incisors and coordinated maxilla and mandible, while orthognathic surgeries are usually used to the patients with relatively normal incisors along with horizontal prognathic maxilla and mandible [3,4]
In the BP patients with Angle Class I malocclusion, the general surgical approach is anterior segmental osteotomy(ASO) which is useful for correcting dental spaces, anterior open bite, and other dento-maxillofacial deformities [5,6]
Summary
Bimaxillary protrusion (BP) is a common type of dento-maxillofacial deformities, predominantly in African and Asian adults [1,2] The main clinical manifestations of BP are protrusive and proclined incisors, which are usually combined with lip incompetence, gummy smile, mentalis strain, receding chin, and anterior open bite. 3) simulation of different surgical procedures to obtain the best possible outcomes [13] These goals can be achieved through the design and manufacture of 3D-printing surgical templates and the production of cutting guides can allow the surgeon to intraoperatively reproduce the virtually planned osteotomy and refixation [16,17,18]. The main purpose of this study is to introduce a set of templates transferring the virtual surgical simulation of ASO to the real operation room. This set of templates can guide both the osteotomy and reposition the osteotomized parts with the advantage of simplified preoperative and operative procedures with no need for the traditional model and the additional preparation as well as avoiding the associated errors. Conclusions: The 3D printed surgical template designed in this study can safely and accurately transfer the computer-aided 3D simulation into real practice
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