The use of 3D technologies in the planning of orthognathic operations in patients with anomalies in the development of the jaws

Abstract

Aim. Improving the methods of planning and the surgical stage of the combined treatment of patients with jaw anomalies using 3D technologies and subsequent assessment of the accuracy of the result.Materials and methods. In the period from 2019 to 2021, 90 patients with anomalies in the development of the jaws aged 18 to 45 years were examined and treated. 45 female patients, 45 male. All patients underwent a comprehensive examination and subsequent surgical treatment. Patients were divided into 3 groups depending on the planning method.Results. When evaluating the results of the study, significant differences were found between the control group (I) and group II and the control group (I) and group III with a difference effect from medium, moderate to large, strong in 25 coordinates out of 35 (71%). There was no statistically significant difference between groups II and III. The average difference in coordinates between planned movements and postoperative results in comparison between groups I and II, groups I and III is from 0.69 mm. up to 2.14 mm. The average difference in coordinates between groups 2 and 3 is from 0.20 mm. up to 0.54 mm. The maximum differences between the planned and postoperative results were revealed in the coordinates responsible for vertical movements, as well as various angles (pitch, roll and yaw), the average deviation for all three groups was in the range from 2.02 mm to 3.13 mm. This fact led to the conclusion that 3D planning allows to achieve more predictable results in the surgical stage of the complex treatment of patients with jaw anomalies. However, for a more accurate assessment of the quality of planning, a larger sample size of patients is needed, with the possible inclusion of a larger number of reference points.Conclusions. The widespread digitalization of the medical industry has made it possible to introduce many tools aimed at increasing the accuracy of preoperative planning, as well as visualizing future changes in the patient. Three-dimensional (3D) methods of virtual visualization and planning allow you to combine information from the soft tissues of the face, skeleton and dentition. Computer simulation of operations is becoming increasingly important in the field of maxillofacial surgery, as the technology offers improved possibilities for preoperative planning and reduction of possible risk factors at the preoperative, operative and postoperative stages.