Do patient-specific cutting guides and plates improve the accuracy of maxillary repositioning in hemifacial microsomia? |
| |
| Institution: | 1. Department of Oral and Craniomaxillofacial Surgery, Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology,National Clinical Research Center for Oral Diseases, Shanghai, China;3. Columbia Asia Hospital, Kolkata, India;1. Graduate Institute of Craniofacial and Dental Science, Chang Gung University, Taoyuan, Taiwan;2. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan;3. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan;4. Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan;1. Medical Student, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands; Department of Plastic and Oral Surgery, Boston Children''s Hospital, Boston, MA;2. Attending Surgeon, Department of Plastic and Oral Surgery, Boston Children''s Hospital, Boston, MA;3. Resident, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands;4. Resident, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands;6. Senior Research Associate, Great Ormond Street Institute of Child Health, University College London, London, UK;5. Attending Surgeon and Associate Professor, Department of Oral and Maxillofacial Surgery, The Dutch Craniofacial Centre, Rotterdam, The Netherlands; Associate Professor, Department of Plastic and Oral Surgery, Boston Children''s Hospital, Boston, MA; Associate Professor, Great Ormond Street Institute of Child Health, University College London, London, UK;1. Chief Resident, Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan;2. Visiting Staff, Department of Periodontics, Chang Gung Memorial Hospital, Taipei, Taiwan;3. Associate Professor, Department of Periodontics, Chang Gung Memorial Hospital, Taipei; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan;4. Visiting Staff, Department of Periodontics, Chang Gung Memorial Hospital, Taipei; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan;6. Department Head, Department of Periodontics, Chang Gung Memorial Hospital, Taipei; Graduate Institute of Dental and Craniofacial Science, Chang Gung University, Taoyuan, Taiwan;1. Oral and Maxillofacial Surgeon, Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil;2. Oral and Maxillofacial Surgeon and Oral and Maxillofacial Radiologist, Private Office, São Luís, Maranhão, Brazil;3. Department of Dentistry, Federal University of Juiz de Fora/Governador Valadares Campus, Governador Valadares, Minas Gerais, Brazil;4. Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba, São Paulo, Brazil;5. Division of Oral and Maxillofacial Surgery, University Hospital of Federal University of Juiz de Fora, Minas Gerais, Brazil;1. Hospital Universitario Virgen de las Nieves, Oral & Maxillofacial Surgery, Av. de las Fuerzas Armadas, 2 18014 Granada, Spain;2. Hospital General Universitario Gregorio Marañón, Oral & Maxillofacial Surgery, Calle del Dr. Esquerdo, 46, 28007 Madrid, Spain |
| |
| Abstract: | The aim of this retrospective study was to use computer-aided design and manufacturing (CAD/CAM) patient-specific plates and cutting guides for the waferless positioning and fixation of the maxilla after bimaxillary osteotomies in cases of hemifacial microsomia with condylar dysplasia or absence of the temporomandibular joint (TMJ), and to compare the results with the CAD/CAM fabricated surgical wafer by 3-dimensional analysis. Eighteen patients were selected from the hospital database, preoperative surgical planning and simulation were done on 3-dimensional computed tomographic models for all patients, and they were divided into Group I – in which CAD/CAM patient-specific cutting guides and plates were used; and Group II – in which CAD/CAM fabricated surgical wafers were used. Finally, the outcome was evaluated by comparing planned with postoperative outcomes. The largest discrepancies of the Le Fort I segment were 0.50 (0.18) mm in the anteroposterior direction and 0.82 (0.60)° in the yaw orientation with Group I. The largest discrepancies of the Le Fort I segment were 1.32 (1.40) mm in superioinferior direction and 8.48 (7.73)° in the yaw orientation with Group II. The CAD/CAM patient-specific cutting guides and plates proved to be reliable and have great value in improving the accuracy in repositioning the Le Fort I segment and in the efficacy of orthognathic treatment of hemifacial microsomia with condylar dysplasia or no TMJ. The CAD/CAM patient-specific cutting guides and plates are therefore a useful alternative to the wafer technique. |
| |
| Keywords: | Hemifacial microsomia computer-aided design and manufacturing patient specific cutting guides and plates surgical wafer |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
