Daniel Holzinger1, Philipp Juergens2, Kamal Shahim3, Mauricio Reyes3, Kurt Schicho4, Gabriele Millesi4, Christos Perisanidis4, Hans-Florian Zeilhofer2, Rudolf Seemann4. 1. Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria. Electronic address: daniel.holzinger@meduniwien.ac.at. 2. Department for Cranio-Maxillofacial and Oral Surgery, University of Basel, Basel, Switzerland. 3. Institute for Surgical Technology and Biomechanics, University of Bern, Switzerland. 4. Department of Cranio-Maxillofacial and Oral Surgery, Medical University of Vienna, Vienna, Austria.
Abstract
PURPOSE: The purpose of this study was to provide a quantitative accuracy assessment of soft tissue predictions generated by a computer-aided maxillofacial planning system in patients undergoing orthognathic surgery following the "surgery-first" treatment. MATERIALS AND METHODS: For this study, we looked at 16 patients with open bite dentofacial-dysmorphosis who underwent orthognathic surgery. Surgeries were planned using conventional sketches and the newly developed computer-assisted SOTIRIOS planning software (developed by the authors). Validation procedures were performed in the following steps: (1) Standardized registration of the pre- and postoperative CT volumes; (2) Automated adjustment of the bone-related preoperative planning to the actual postoperative bony displacement; (3) Simulation of soft tissue changes according to the definitive bony movements; and (4) Calculation of soft tissue differences between the predicted and the actual 6-month postoperative results by distance mapping. RESULTS: The program produced a clinically satisfactory 3D soft tissue prediction, with a mean error of 1.46 mm ± 1.53 mm. The program was suitable for use in virtual surgical planning without technical assistance. CONCLUSION: This study shows that the program is quite accurate, enabling the surgeon to predict the outcome of the soft tissue. This has the potential to promote the routine application of the surgery-first approach in patients suffering from open bite.
PURPOSE: The purpose of this study was to provide a quantitative accuracy assessment of soft tissue predictions generated by a computer-aided maxillofacial planning system in patients undergoing orthognathic surgery following the "surgery-first" treatment. MATERIALS AND METHODS: For this study, we looked at 16 patients with open bite dentofacial-dysmorphosis who underwent orthognathic surgery. Surgeries were planned using conventional sketches and the newly developed computer-assisted SOTIRIOS planning software (developed by the authors). Validation procedures were performed in the following steps: (1) Standardized registration of the pre- and postoperative CT volumes; (2) Automated adjustment of the bone-related preoperative planning to the actual postoperative bony displacement; (3) Simulation of soft tissue changes according to the definitive bony movements; and (4) Calculation of soft tissue differences between the predicted and the actual 6-month postoperative results by distance mapping. RESULTS: The program produced a clinically satisfactory 3D soft tissue prediction, with a mean error of 1.46 mm ± 1.53 mm. The program was suitable for use in virtual surgical planning without technical assistance. CONCLUSION: This study shows that the program is quite accurate, enabling the surgeon to predict the outcome of the soft tissue. This has the potential to promote the routine application of the surgery-first approach in patients suffering from open bite.
Authors: Hugo Santos Cunha; Cícero André da Costa Moraes; Rodrigo de Faria Valle Dornelles; Everton Luis Santos da Rosa Journal: Oral Maxillofac Surg Date: 2020-11-08