IADR Abstract Archives
In-house 3D-printed Hybrid Teeth-and-bone-borne Wafers for Le Fort I Osteotomy
Objectives: Virtual surgical planning (VSP) has gained significant traction and is used in orthognathic surgeries as an alternative to traditional surgical planning (TSP). Virtual surgical plans are transferred to operations with occlusal-based splints to guide movements of jaws. Although 3-dimensional (3D) printing has improved splint fabrication process, inaccuracies persist. This case series presents a novel design of patient-specific guides for osteotomies and repositioning of the maxilla in Le Fort I osteotomy. This design circumvents issues associated with occlusal-based splints and aims to improve accuracy in post-surgical outcomes.
Virtual surgical planning (VSP) has gained significant traction and is used in orthognathic surgeries as an alternative to traditional surgical planning (TSP). Virtual surgical plans are transferred to operations with occlusal-based splints to guide movements of jaws. Although 3-dimensional (3D) printing has improved splint fabrication process, inaccuracies persist. This case series presents a novel design of patient-specific guides for osteotomies and repositioning of the maxilla in Le Fort I osteotomy. This design circumvents issues associated with occlusal-based splints and aims to improve accuracy in post-surgical outcomes.
Methods: We present a hybrid design of patient-specific cutting and repositioning templates that are both teeth-borne and bone-borne for accurate osteotomies and repositioning of the maxilla in the Le Fort I osteotomy, and share our experience in the use of these fully in-house designed and printed guides. Each surgery was performed with hybrid surgical templates and the outcome was verified intraoperatively with 3D-printed occlusal wafers. Preliminary analysis was done with 3D color-coded heatmaps to validate the predictability and accuracy of orthognathic surgery, through a comparison of the 3D models of the virtual planning and postoperative CBCT by superimposing them based on the unchanged skull base.
Results: The generated 3D colour maps show accurate results with a mean geometric deviation of less than 2mm.
Conclusions: In conclusion, in-house virtual surgical planning in orthognathic surgery is able to offer predictable results, and we aim to improve further with calibration between the operating table and the computer over time.
Virtual surgical planning (VSP) has gained significant traction and is used in orthognathic surgeries as an alternative to traditional surgical planning (TSP). Virtual surgical plans are transferred to operations with occlusal-based splints to guide movements of jaws. Although 3-dimensional (3D) printing has improved splint fabrication process, inaccuracies persist. This case series presents a novel design of patient-specific guides for osteotomies and repositioning of the maxilla in Le Fort I osteotomy. This design circumvents issues associated with occlusal-based splints and aims to improve accuracy in post-surgical outcomes.
Methods: We present a hybrid design of patient-specific cutting and repositioning templates that are both teeth-borne and bone-borne for accurate osteotomies and repositioning of the maxilla in the Le Fort I osteotomy, and share our experience in the use of these fully in-house designed and printed guides. Each surgery was performed with hybrid surgical templates and the outcome was verified intraoperatively with 3D-printed occlusal wafers. Preliminary analysis was done with 3D color-coded heatmaps to validate the predictability and accuracy of orthognathic surgery, through a comparison of the 3D models of the virtual planning and postoperative CBCT by superimposing them based on the unchanged skull base.
Results: The generated 3D colour maps show accurate results with a mean geometric deviation of less than 2mm.
Conclusions: In conclusion, in-house virtual surgical planning in orthognathic surgery is able to offer predictable results, and we aim to improve further with calibration between the operating table and the computer over time.