Abstract
BackgroundModel surgery is an integral part of the planning procedure in orthognathic surgery. Most concepts comprise cutting the dental cast off its socket. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation.MethodsIn the course of development of the system various articulator types were evaluated with regard to their capability to provide a means of realizing the concepts comprised of the KD-MMS. Special attention was dedicated to the ability to perform three-dimensional displacements without cutting of plaster casts. Various utilities were developed to facilitate maxillary displacement in accordance to the planning. Objectives of this development comprised the ability to implement the values established in the course of two-dimensional ceph planning.ResultsThe system - KD-MMS comprises a set of hardware components as well as a defined procedure. Essential hardware components are red spacer and blue mounting plates. The blue mounting plates replace the standard yellow SAM mounting elements. The red spacers provide for a defined leeway of 8 mm for three-dimensional movements. The non-destructive approach of the KD-MMS makes it possible to conduct different model surgeries with the same plaster casts as well as to restore the initial, pre-surgical situation at any time. Thereby, surgical protocol generation and gnathologic splint construction are facilitated.ConclusionsThe KD-MMS hardware components in conjunction with the defined procedures are capable of increasing efficiency and accuracy of model surgery and splint construction. In cases where different surgical approaches need to be evaluated in the course of model surgery, a significant reduction of chair time may be achieved.
Highlights
Model surgery – according to Epker, Stella, Fisch [1]: Definitive Model Surgery, according to Erickson, Bell, Goldsmith [2]: Analytical Model Surgery or with regard to future developments [3,4,5]: 3D Virtual Treatment Planning – is an integral part of the planning procedure in orthognathic surgery.The process pursues the following objectives:– Transfer of data gained from lateral ceph analysis (2D) with regard to clinical, photographic and functional findings to a three-dimensional model (3D)– Determination of displacement values for the surgical intervention– Gnathologic splint construction – Realization of aspired movements during surgerySemi-adjustable articulators, mostly SAM-type products, serve for the three-dimensional treatment planning
The KD-MMS comprises a set of hardware components (Figure 4) as well as a defined procedure
Hardware components The following compendium provides an overview of the KD-MMS components
Summary
Model surgery – according to Epker, Stella, Fisch [1]: Definitive Model Surgery, according to Erickson, Bell, Goldsmith [2]: Analytical Model Surgery or with regard to future developments [3,4,5]: 3D Virtual Treatment Planning – is an integral part of the planning procedure in orthognathic surgery.The process pursues the following objectives:– Transfer of data gained from lateral ceph analysis (2D) with regard to clinical, photographic and functional findings to a three-dimensional model (3D)– Determination of displacement values for the surgical intervention (yaw, pitch, roll [2])– Gnathologic splint construction – Realization of aspired movements during surgerySemi-adjustable articulators, mostly SAM-type products, serve for the three-dimensional treatment planning. Model surgery – according to Epker, Stella, Fisch [1]: Definitive Model Surgery, according to Erickson, Bell, Goldsmith [2]: Analytical Model Surgery or with regard to future developments [3,4,5]: 3D Virtual Treatment Planning – is an integral part of the planning procedure in orthognathic surgery. Three-dimensional alignment of the maxillary dental cast to a reference plane (Axis Orbital Plane in SAM) is achieved through face bow registration [6,7,8,9,10]. In comparison to conventional methods of face bow transfer, three-dimensional virtual computer assisted planning appears to be more accurate [11]. The maxillary dental cast is separated from its socket approximately at the level of the future osteotomy site. The standardized spacer plates of the KD-MMS provide for a non-destructive, reversible and reproducible means of maxillary and/or mandibular plaster cast separation
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