Simona Mazzoni1, Alberto Bianchi2, Giulio Schiariti3, Giovanni Badiali4, Claudio Marchetti5. 1. Assistant, Department of Maxillofacial Surgery, S Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. Electronic address: simonamazzoni@libero.it. 2. Assistant, Department of Maxillofacial Surgery, S Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 3. Student, Medical School, University of Bologna, Bologna, Italy. 4. PhD Student, Department of Maxillofacial Surgery, S Orsola Malpighi Hospital, University of Bologna, Bologna, Italy. 5. Department Head and Professor, Department of Maxillofacial Surgery, S Orsola Malpighi Hospital, University of Bologna, Bologna, Italy.
Abstract
PURPOSE: The purpose of the present study was to develop a computer-aided design (CAD) and computer-aided manufacturing (CAM) technique that enabled fabrication of surgical cutting guides and titanium fixation plates that would allow the upper maxilla to be repositioned correctly without a surgical splint in orthognathic patients. MATERIALS AND METHODS: Ten patients were recruited. A complete CAD-CAM workflow for orthognathic surgery has 3 steps: 1) virtual planning of the surgical treatment, 2) CAD-CAM and 3-dimensional printing of customized surgical devices (surgical cutting guide and titanium fixation plates), and 3) computer-aided surgery. Upper maxilla repositioning was performed in a waferless manner using a CAD-CAM device: the surgical cutting guide was used during surgery to pilot the osteotomy line that had been planned preoperatively at the computer and the custom-made fixation titanium plates allowed desired repositioning of the maxilla. RESULTS: To evaluate the reproducibility of this CAD-CAM orthognathic surgical method, the virtually planned and actually achieved positions of the upper maxilla were compared. Overlap errors using a threshold value smaller than 2 mm were evaluated, and the frequency of such errors was used as a measurement of accuracy. By this definition, the accuracy was 100% in 7 patients (range in all patients, 62 to 100%; median, 92.7%). CONCLUSION: These results tend to confirm that the use of CAD-CAM cutting guides and customized titanium plates for upper maxilla repositioning represents a promising method for the accurate reproduction of preoperative virtual planning without the use of surgical splints.
PURPOSE: The purpose of the present study was to develop a computer-aided design (CAD) and computer-aided manufacturing (CAM) technique that enabled fabrication of surgical cutting guides and titanium fixation plates that would allow the upper maxilla to be repositioned correctly without a surgical splint in orthognathic patients. MATERIALS AND METHODS: Ten patients were recruited. A complete CAD-CAM workflow for orthognathic surgery has 3 steps: 1) virtual planning of the surgical treatment, 2) CAD-CAM and 3-dimensional printing of customized surgical devices (surgical cutting guide and titanium fixation plates), and 3) computer-aided surgery. Upper maxilla repositioning was performed in a waferless manner using a CAD-CAM device: the surgical cutting guide was used during surgery to pilot the osteotomy line that had been planned preoperatively at the computer and the custom-made fixation titanium plates allowed desired repositioning of the maxilla. RESULTS: To evaluate the reproducibility of this CAD-CAM orthognathic surgical method, the virtually planned and actually achieved positions of the upper maxilla were compared. Overlap errors using a threshold value smaller than 2 mm were evaluated, and the frequency of such errors was used as a measurement of accuracy. By this definition, the accuracy was 100% in 7 patients (range in all patients, 62 to 100%; median, 92.7%). CONCLUSION: These results tend to confirm that the use of CAD-CAM cutting guides and customized titanium plates for upper maxilla repositioning represents a promising method for the accurate reproduction of preoperative virtual planning without the use of surgical splints.
Authors: Maysa Nogueira de Barros Melo; Ítalo Miranda do Vale Pereira; Alexander Tadeu Sverzut; Cássio Edvard Sverzut; Alexandre Elias Trivellato Journal: J Maxillofac Oral Surg Date: 2022-01-17
Authors: Georges E Daoud; Dante L Pezzutti; Calvin J Dolatowski; Ricardo L Carrau; Mary Pancake; Edward Herderick; Kyle K VanKoevering Journal: J Mater Res Date: 2021-07-06 Impact factor: 3.089
Authors: Leonardo Frizziero; Gian Maria Santi; Christian Leon-Cardenas; Giampiero Donnici; Alfredo Liverani; Paola Papaleo; Francesca Napolitano; Curzio Pagliari; Giovanni Luigi Di Gennaro; Stefano Stallone; Stefano Stilli; Giovanni Trisolino; Paola Zarantonello Journal: Bioengineering (Basel) Date: 2021-05-26