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Title: Accuracy of Upper Jaw Positioning With Intermediate Splint Fabrication After Virtual Planning in Bimaxillary Orthognathic Surgery
Authors: SUN, Yi 
Luebbers, Heinz-Theo
Agbaje, Jimoh Olubanwo
Schepers, Serge
Vrielinck, Luc
POLITIS, Constantinus 
Issue Date: 2013
Source: JOURNAL OF CRANIOFACIAL SURGERY, 24 (6), p. 1871-1876
Abstract: The purpose of the study is to present and discuss a workflow regarding computer-assisted surgical planning for bimaxillary surgery and intermediate splint fabrication. This study describes a protocol starting from wax bite registration to fabrication of the necessary intermediate splint. The procedure is a proof of concept to replace not only the model surgery but also facebow registration and transfer from facebow to articulator. Three different modalities were utilized to obtain this goal: cone beam computed tomography (CBCT), optical dental scanning, and 3-dimensional printing. A universal registration block was designed to register the optical scan of the wax bite to the CBCT data set. Integration of the wax bite avoided problems related to artifacts caused by dental fillings in the occlusal plane of the CBCT scan. Fifteen patients underwent bimaxillary orthognathic surgery. The printed intermediate splint was used during the operation for each patient. A postoperative CBCT scan was taken and registered to the preoperative CBCT scan. The difference between the planned and the actual bony surgical movement at the edge of the upper central incisor was 0.50 ± 0.22 mm in sagittal, 0.57 ± 0.35 mm in vertical, and 0.38 ± 0.35 mm in horizontal direction (midlines). There was no significant difference between the planned and the actual surgical movement in 3 dimensions: sagittal (P = 0.10), vertical (P = 0.69), and horizontal (P = 0.83). In conclusion, under clinical circumstances, the accuracy of the designed intermediate splint satisfied the requirements for bimaxillary surgery.
Notes: Politis, C (reprint author), Univ Hosp Leuven, KU Leuven Dept Oral Hlth Sci & Oral & Maxillofaci, Kapucijnenvoer 7, B-3000 Louvain, Belgium.
Keywords: computer-assisted surgery; virtual surgical planning; bimaxillary surgery; digital intermediate splint; 3D printer
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ISSN: 1049-2275
e-ISSN: 1536-3732
DOI: 10.1097/SCS.0b013e31829a80d9
ISI #: 000330354500034
Rights: © 2013 by Mutaz B. Habal, MD.
Category: A1
Type: Journal Contribution
Validations: ecoom 2015
Appears in Collections:Research publications

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