Treatment Planning Of Orthognathic Surgery Research Articles

Role of Three-Dimensional Printing in Treatment Planning for Orthognathic Surgery: A Systematic Review.

Three-dimensional (3D) printing refers to a wide range of additive manufacturing processes that enable the construction of structures and models. It has been rapidly adopted for a variety of surgical applications, including the printing of patient-specific anatomical models, implants and prostheses, external fixators and splints, as well as surgical instrumentation and cutting guides. In comparison to traditional methods, 3D-printed models and surgical guides offer a deeper understanding of intricate maxillofacial structures and spatial relationships. This review article examines the utilization of 3D printing in orthognathic surgery, particularly in the context of treatment planning. It discusses how 3D printing has revolutionized this sector by providing enhanced visualization, precise surgical planning, reduction in operating time, and improved patient communication. Various databases, including PubMed, Google Scholar, ScienceDirect, and Medline, were searched with relevant keywords. A total of 410 articles were retrieved, of which 71 were included in this study. This article concludes that the utilization of 3D printing in the treatment planning of orthognathic surgery offers a wide range of advantages, such as increased patient satisfaction and improved functional and aesthetic outcomes.

Cephalometric norms for the north Indian population: A systematic review.

The cephalometric norms for orthognathic surgery (COGS analysis) are the standard benchmark in cephalometrics for any orthognathic surgical diagnosis and treatment planning. Since the introduction of cephalometrics by Broadbent, numerous studies have been conducted to establish craniofacial norms of different ethnicities. Most of these studies, however, determined craniofacial norms for Caucasian people and may not be applicable to other ethnic groups due to differences in their facial appearance. Therefore, it is essential to study and compare the existing cephalometric parameters between Caucasians and Indians to validate their application during the treatment planning of the orthognathic surgery. This review focuses on studying the cephalometric norms for the North Indian (NI) population and establishing the COGS analysis for the population of North India. The objective is to determine the cephalometric parameters of Angle's dental and skeletal Class I faces for the NI population. The following databases were searched for the present study -PubMed, Ovid MEDLINE, and EMBASE. The initial inclusion criteria comprised studies written in English and quoting cephalometric norms in Indian population. The time period of publications was not determined. The quality features evaluated were sample description, variables analyzed, and how cephalometric standards were evaluated. Initially, 49 articles were retrieved. After removal of the duplicated records and assessing for the eligibility, four articles met the inclusion criteria. These four articles were included in the systematic review. The NI people are characterized by having small cranial base, short facial height, protrusive chin, and more inclination of mandibular incisors in comparison with Caucasians. Due to limited research on the Central Indian cephalometric norms, the Caucasian norms are still referred for the diagnosis and treatment planning of orthognathic surgery for NI population.

Soft tissues cephalometric norms for a sample of Sudanese adults. Part I: Legan and Burstone analysis

ABSTRACT Purpose: To establish soft tissues cephalometric norms for orthognathic surgery in a sample of Sudanese adults. Materials and Methods: A total of 106 lateral cephalograms of Sudanese adults (55 females and 51 males) aged between 18 and 25 years (mean 22.8 years) were manually traced and analysed using Legan and Burstone Cephalometric analysis for orthognathic Surgery (COGS). Results: Sudanese sample, in comparison to Caucasian, had a more convex profile with larger angle of convexity and more prognathic maxillae, obtuse lower face-throat angle, more acute nasolabial angle, protrusive upper and lower lips with deeper labiomental sulci and greater maxillary incisors exposure with larger interlabial gap. Males had greater maxillary and mandibular prognathism, more obtuse lower face-throat angle and vertical height depth ratio than females. Females had larger vertical lip chin ratio, maxillary incisor exposure and interlabial gap. Conclusion: Considerable differences between the soft tissue profile configuration of Sudanese and Caucasian adults exist and also between Sudanese and other populations. These variations should be taken into account during diagnosis and treatment planning of orthognathic surgery.

Facial Versus Skeletal Landmarks for Anterior-Posterior Diagnosis in Orthognathic Surgery and Orthodontics: Are They the Same?

The purpose of this investigation was to evaluate diagnostic agreement in anterior-posterior (AP) categorization of the maxilla and mandible between a skeletal-landmark analysis and a facial-landmark analysis for treatment planning of orthognathic surgery and orthodontics. This retrospective, consecutive case series of adult patients who presented to the Mayo Clinic orthodontic department compared maxillary and mandibular AP diagnoses. Steiner's analysis of the sella-nasion-A point angle and sella-nasion-B point angle was used for a skeletal-landmark diagnosis. Element II of Andrews' 6 elements of orofacial harmony was used for a facial-landmark diagnosis. Both diagnoses were categorized as either deficient, optimal, or excessive for each jaw. Categorization of the skeletal landmark was determined by normative data, whereas the facial landmark provides a customized categorization unique to each individual. Weighted κ statistics were completed to test agreement between the categories determined by the skeletal and facial landmarks. The maxilla showed poor agreement, and the mandible showed slight agreement. No agreement was found for AP categorization of the maxilla and mandible between skeletal-landmark and facial-landmark analyses. Most mandibles were diagnosed as retrognathic by the facial landmark, whereas most were diagnosed as optimal by the skeletal landmark. When the 2 landmarks disagreed, the facial landmark defined the optimal position farther anterior. The landmark chosen for diagnosis will impact the optimal jaw position and can affect orthognathic and orthodontic outcomes.

3D Printed Models in 3D Virtual Treatment Planning of Orthognathic Surgery

3D Printed Models in 3D Virtual Treatment Planning of Orthognathic Surgery

3D Virtual Treatment Planning of Orthognathic Surgery. A Step-by-step Approach for Orthodontists and Surgeons by Gwen R.J. Swennen Berlin, Germany: Springer, 2017

Guijarro-Martínez, Raquel MD, DMD; Hernández-Alfaro, Federico MD, DMD Author Information

Automatic repositioning of jaw segments for three-dimensional virtual treatment planning of orthognathic surgery

PurposeTo develop a computer-based method for automating the repositioning of jaw segments in the skull during three-dimensional virtual treatment planning of orthognathic surgery. The method speeds up the planning phase of the orthognathic procedure, releasing surgeons from laborious and time-consuming tasks. Materials and methodsThe method finds the optimal positions for the maxilla, mandibular body, and bony chin in the skull. Minimization of cephalometric differences between measured and standard values is considered. Cone-beam computed tomographic images acquired from four preoperative patients with skeletal malocclusion were used for evaluating the method. ResultsDentofacial problems of the four patients were rectified, including skeletal malocclusion, facial asymmetry, and jaw discrepancies. ConclusionsThe results show that the method is potentially able to be used in routine clinical practice as support for treatment-planning decisions in orthognathic surgery.

Timing of Three-Dimensional Virtual Treatment Planning of Orthognathic Surgery

The purpose of this article is to evaluate the timing for three-dimensional (3D) virtual treatment planning of orthognathic surgery in the daily clinical routine. A total of 350 consecutive patients were included in this study. All patients were scanned following the standardized "Triple CBCT Scan Protocol" in centric relation. Integrated 3D virtual planning and actual surgery were performed by the same surgeon in all patients. Although clinically acceptable, still software improvements especially toward 3D virtual occlusal definition are mandatory to make 3D virtual planning of orthognathic surgery less time-consuming and more user-friendly to the clinician.

The three-dimensional virtual treatment planning of orthognathic surgery—the digital era

The three-dimensional virtual treatment planning of orthognathic surgery—the digital era

Development of a simulation system in mandibular orthognathic surgery based on integrated three-dimensional data

PurposeSurgical simulation should reflect the 3D movement of dentition and the resultant movement of the osteotomized segments, which can influence surgical outcome. The present study was aimed at developing a new simulation system that enables virtual osteotomy of a given surgical situation and evaluation of the bony interference between the osteotomized segments of the mandible.Subjects and methodsThe data of 3D computer tomography (CT) for maxillomandibular dental casts were integrated into the standard coordinates of a 3D cephalogram. To evaluate the accuracy of the system, measurement errors of the 3D CT virtual model from a dry skull were compared with the computer simulation system and a contact-type 3D digitizer. To examine the clinical accessibility, 15 mandibular prognathism patients with mild to severe asymmetry were evaluated with the simulation program.ResultsThe average error of measurement in all directions was 1.31 mm. It was possible to simulate various osteotomy procedures by conversion of the 3D coordinates of the dental cast and CT data into the standard coordinate system of a 3D cephalogram. Using this simulation system, it was possible to prevent condylar torque or segment malpositioning by removing the bony interference visualized by a 3D virtual model.ConclusionA new system, which enables the precise visualization of osteotomized segments and calculation of bony interference, was proposed in the present study. This new system provides an acceptable precision of treatment planning of orthognathic surgery, especially for facial asymmetry.

Facial soft tissue: the alpha and omega of treatment planning in orthognathic surgery

Facial soft tissue: the alpha and omega of treatment planning in orthognathic surgery

Three-Dimensional Treatment Planning of Orthognathic Surgery in the Era of Virtual Imaging

The aim of this report was to present an integrated 3-dimensional (3D) virtual approach toward cone-beam computed tomography-based treatment planning of orthognathic surgery in the clinical routine. We have described the different stages of the workflow process for routine 3D virtual treatment planning of orthognathic surgery: 1) image acquisition for 3D virtual orthognathic surgery; 2) processing of acquired image data toward a 3D virtual augmented model of the patient's head; 3) 3D virtual diagnosis of the patient; 4) 3D virtual treatment planning of orthognathic surgery; 5) 3D virtual treatment planning communication; 6) 3D splint manufacturing; 7) 3D virtual treatment planning transfer to the operating room; and 8) 3D virtual treatment outcome evaluation. The potential benefits and actual limits of an integrated 3D virtual approach for the treatment of the patient with a maxillofacial deformity are discussed comprehensively from our experience using 3D virtual treatment planning clinically.

Benefits and limitations of three-dimensional virtual planning of orthognathic surgery

Recent advances in three-dimensional (3D) medical image computing allow unprecedented virtual diagnosis, treatment planning and evaluation of treatment outcome of maxillofacial deformity. The introduction of cone-beam computed tomography (CBCT) scanning in a natural vertical seated position has made a major breakthrough in treatment planning of orthognathic surgery.

Assessment of the relationships among posture, maxillomandibular denture complex, and soft-tissue profile of aesthetic adult Korean women.

The objective of this study was to assess the relationships among the posture, the maxillomandibular denture complex, and the soft-tissue profile of aesthetic adult Korean women. From an initial group of 346 women, the authors examined 28 beautiful adult Korean women who had normal vertical and sagittal skeletal relationships and normal occlusion. There were no differences in the inclinations of the incisors to the occlusal planes in the maxilla and the mandible in the data for Korean women vs. Arnett's data for white women. However, the overbite and overjet in Korean women were slightly smaller than in white women. AB to maxillary occlusal plane angle (MxOP) represented the anteroposterior denture base discrepancy to the occlusal plane. Angulation of the maxillary occlusal plane to the Frankfurt (FH) plane and the true vertical line at submasale (TVL) (Sn) was a little steeper in Korean women than in white women. The FH plane was almost parallel to the true horizontal line in Korean women who had normal vertical and sagittal skeletal relationships and normal occlusion. With regard to soft-tissue variables, the upper lip length (Sn-Stms), interlabial gap, upper incisor exposure, nasolabial angle, lip and nose tip projection value, and TVL (Sn)-to-upper lip line (UL) angle showed interracial differences. The results of this study can assist in the diagnosis and treatment planning of orthognathic surgery.

Three-dimensional virtual imaging of facial skeleton and dental morphologic condition for treatment planning in orthognathic surgery

The improvement of esthetics and function, including the occlusal relationship, needs to be carefully considered in treatment planning for the success of orthognathic surgery. Conventional lateral cephalograms and dental study casts have been used usually for the assessment of skeletal morphologic condition and occlusion, respectively, in planning procedures. However, these traditional techniques do not allow for simultaneous evaluation of the skeletal morphologic condition and the occlusal harmony. A new technique has been developed that combines the conventional clinical diagnostic materials, cephalograms, and dental study casts to produce a 3-dimensional virtual image for routine practice. A 3-dimensional graphic image of dental study casts was generated with a laser surface scanner. A 3-dimensional skeletal image was constructed based on the coordinates of anatomic landmarks registered on frontal and lateral cephalograms. The image of the study cast was then set up with the 3-dimensional skeletal image to create a 3-dimensional dataset of the virtual image. The 3-dimensional virtual image, combining the cephalometric and the dental study cast information, permits simultaneous display of skeletal morphologic condition and occlusal relationship. This 3-dimensional virtual imaging can be helpful in planning orthodontic–surgical treatment and in providing graphic information to the patient. This article describes the technique and outline. A clinical application with this imaging technique is also demonstrated. (Am J Orthod Dentofacial Orthop 1999;116:126-31)

A virtual cast model for treatment planning in orthognathic surgery

A virtual cast model for treatment planning in orthognathic surgery

Three-dimensional dental cast analyzing system using laser scanning

The purpose of this article is to introduce the outline of our newly developed three-dimensional dental cast analyzing system with laser scanning, and its preliminary clinical applications. The system is composed of a measuring device with a slit-ray laser projector and two sets of coupled charged devised video cameras, an image processing unit, a 16-bit personal computer as a controller, and an engineering workstation as a post processor. The dental cast is projected and scanned with a slit-ray laser beam. The raster coordinates of the target are determined with an image processor. Triangulation is applied to determine the location of each point. Generation of three-dimensional graphics of the dental cast takes approximately 40 minutes. About 90,000 sets of X,Y,Z coordinates are stored in the main memory of the microcomputer. The measurement error is less than 0.05 mm. Besides the conventional linear and angular measurements of the dental cast, we are also able to demonstrate the size of the palatal surface area and the volume of the oral cavity. The advantage of this system is that it facilitates the otherwise complicated and time-consuming mock surgery necessary for treatment planning in orthognathic surgery. (Am J Orthod Dentofac Orthop 1996;110:365-9.)

Custom-made condylar inserts for repositioning casts in articulators

This technique permits temporary repositioning of the condylar elements of a dental articulator for the construction of orthotic prostheses and treatment planning in orthognathic surgery. The procedure is simple and adaptable to various types of articulators in current use. A single set of cast may be mounted in multiple relationships with custom-made inserts that may be retained as a record of the treatment relationship of the casts.