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Virtual planning in Le Fort III distraction osteogenesis: A case series
Authors:Herman Vercruysse  Josep Rubio-Palau  Elke Van de Casteele  Nasser Nadjmi  Mania De Praeter  David Dunaway
Affiliation:1. Department of Maxillofacial Surgery, ZMACK Association, University Hospital of Antwerp, Edegem, Belgium;2. Division of Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Esplugues de Llobregat, Barcelona, Spain;3. Division of Paediatric Maxillofacial Surgery, Department of Paediatric Surgery, Hospital Sant Joan de Deu, Barcelona Children''s Hospital, Esplugues de Llobregat, Barcelona, Spain;4. Department of Maxillofacial Surgery, All for Research VZW, ZMACK Association, AZ MONICA Antwerp, Antwerp, Belgium;5. Department of Neurosurgery, University Hospital Antwerp, Edegem, Belgium;6. Department of Plastic Surgery, Great Ormond Street Hospital for Children, Great Ormond Street, London, WC1N 3JH, United Kingdom;7. Faculty of Medicine & Health Sciences, University of Antwerp, Campus Drie Eiken, Universiteits-plein 1, 2610 Antwerp, Belgium;1. Department of Craniofacial and Special Care Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA;2. Department of Orthodontics, School of Dentistry, University of Detroit Mercy, Detroit, MI, USA;3. Division of Plastic and Reconstructive Surgery, University Hospitals Cleveland Medical Center, School of Medicine, Case Western Reserve University, Cleveland, OH, USA;1. Department of Oral & Cranio-maxillofacial Surgery, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China;2. National Clinical Research Center for Oral Diseases, Shanghai, China;3. Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, China;1. Department of Oral and Maxillofacial Surgery, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Glueckstrasse 11, 91054, Erlangen, Germany;2. James Cook University Hospital, South Tees NHS Trust, Middlesbrough, UK;3. Department of Medical Informatics, Biometry and Epidemiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Waldstrasse 6, 91054, Erlangen, Germany;4. Department of Radiology, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Krankenhausstrasse 12, 91054, Erlangen, Germany;5. Practice for Oral, Maxillofacial and Plastic Surgery, Fürther Straße 4a, 90429, Nürnberg, Germany;1. Department of Oral and Maxillofacial Surgery, School of Dentistry, Seoul National University, Republic of Korea;2. Department of Orthodontics, School of Dentistry, Dental Science Research Institute, Chonnam National University, Republic of Korea;3. Dental Research Institute, Seoul National University, Republic of Korea;4. HSJ Dental Clinic for Oral and Maxillofacial Surgery, Republic of Korea;1. Department of Head and Neck Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, Japan;2. Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa-ku, Nagoya, Aichi, Nagoya, Japan;3. Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65-banchi, Tsurumai-cho, Showa-ku, Nagoya-shi, Aichi, Nagoya, Japan
Abstract:The objective of this study is to determine the value of using 3D planning tools and 3D printed cutting guides in Le Fort III osteotomies with external frame distraction osteogenesis.The process of planning and transfer of the virtual planning to the operating room is illustrated with 5 case. The virtual planning is transferred to the operating room using a 3D-printed supra-orbital reference bar with puzzle connections for the planned osteotomy guides. Different systems are presented to transfer the vector of distraction and the position of the external midface distractor.Three-dimensional planning tools and cutting guides help to design the Le Fort III osteotomy and the distraction vector, to anticipate possible difficulties, and to avoid adverse events.
Keywords:Le Fort III Osteotomy  Distraction osteogenesis  Three-dimensional planning  Crouzon syndrome  Pfeiffer syndrome  Case series
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