Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
권호 표지

ACCURACY OF DIGITAL MODEL SURGERY FOR ORTHOGNATHIC SURGERY: A PRECLINICAL EVALUATION

악교정 수술을 위한 디지털 모형 수술의 정확성 평가

  • Kim, Bong-Chul (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Park, Won-Se (Department of General Dentistry, College of Dentisry, Yonsei University) ;
  • Kang, Yon-Hee (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Yi, Choong-Kook (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University) ;
  • Yoo, Hyung-Suk (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Kang, Suk-Jin (Orapix) ;
  • Lee, Sang-Hwy (Department of Oral & Maxillofacial Surgery, College of Dentistry, Yonsei University)
  • 김봉철 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 박원서 (연세대학교 치과대학 통합진료과) ;
  • 강연희 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 이충국 (연세대학교 치과대학 구강악안면외과학교실) ;
  • 유형석 (연세대학교 치과대학 교정과학교실) ;
  • 강석진 (㈜Orapix) ;
  • 이상휘 (연세대학교 치과대학 구강악안면외과학교실)
  • Published : 2007.11.30
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Abstract

The accuracy of model surgery is one of important factors which can influence the outcome of orthognathic surgery. To evaluate the accuracy of digitalized model surgery, we tried the model surgery on a software after transferring the mounted model block into a digital model, and compared the results with that of classical manual model surgery. We could get the following results, which can be used as good baseline analysis for the clinical application. 1. We made the 3D scanning of dental model blocks, and mounted on a software. And we performed the model surgery according to the previously arranged surgical plans, and let the rapid prototyping machine produce the surgical wafer. All through these process, we could confirm that the digital model surgery is feasible without difficulties. 2. The digital model surgery group (Group 2) showed a mean error of $0.0{\sim}0.1mm$ for moving the maxillary model block to the target position. And Group 1, which was done by manual model surgery, presented a mean error of $0.1{\sim}1.2mm$, which is definitely greater than those of Group 2. 3. Remounted maxillary model block with the wafers produced by digital model surgery from Group 2 showed the less mean error (0.2 to 0.4 mm) than that produced by manual model surgery in Group 1 (0.3 to 1.4 mm). From these results, we could confirm that the digital model surgery in Group 2 presented less error than manual model surgery of Group 1. And the model surgery by digital manipulation is expected to have less influence from the individual variation or degree of expertness. So the increased accuracy and enhanced manipulability will serve the digital model surgery as the good candidate for the improvement and replacement of the classical model surgery, if careful preparation works for the clinical adjustment is accompanied.

Keywords

References

  1. Anwar M, Harris M : Model surgery for orthognathic planning. British J Oral and Maxillofac Surg 28 : 397, 1990
  2. Bell WH : Correction of the short-face syndrome-vertical maxillary deficiency ; A preliminary report. J Oral Surg 35 : 120, 1977
  3. Buckley MJ, Tucker M : An alternative approach for staging simultaneous maxillary and mandibular osteotomies. Int J Adult Orthod Orthognath Surg 2 : 78, 1987
  4. Cottrell DA, Wolford LM : Altered orthognathic surgical sequencing and a modified approach to model surgery. J Oral Maxillofac Surg 52 : 1020. 1994 https://doi.org/10.1016/0278-2391(94)90165-1
  5. Dahlberg G : Statistical methods for medical and biological students. Interscience Pub., N.Y., 1940. cited from Sandler PJ : Reproducibility of cephalometric measurements. Br J Orthod 15 : 110, 1988
  6. Ellis E : A method to accurately predict the position of the maxillary incisor in two-jaw surgery. J Oral Maxillofac Surg 42 : 404, 1984 https://doi.org/10.1016/S0278-2391(84)80016-6
  7. Ellis E : Accuracy of model surgery. J Oral Maxillofac Surg 48 : 1167, 1990
  8. Ellis E : Accuracy of face-bow transfer. J Oral Maxillofac Surg 50 : 567. 1992
  9. Epker BN. Fish LC : Definitive immediate presurgical planning. In Epker BN. Fish LC : Dentofacial deformities. St. Louis, CV Mosby. 1986. p.146
  10. Erickson KM. Bell WH, Goldsmith DH : Analytical model surgery. In Bell WH : Modern practice in orthognathic and reconstructive surgery. Philadelphia. WB Saunders, 1992. p.216
  11. Hohl TA : Use of an adjustable (anatomic) articulator for cast prediction in segmental surgery. In Bell WH : Surgical correction of dentofacial deformities. Philadelphia. WB Saunders, 1980. p.177
  12. Kahnberg KE, Sunzel B, strand P : Planning and control of vertical dimension in Le Fort I osteotomies. J Craniomax Fac Surg 15 : 243, 1987
  13. Marko JV : Simple hinge and semiadjustable articulators in orthognathic surgery. Am J Orthod Dentofac Orthop 90 : 44. 1986
  14. Nattostad A, Vedtofte P, Mosekilde E : The siginificance of an erroneous recording of the centre of mandibular rotation in orthognathic surgery. J Craniomax Fac Surg 19 : 259. 1991
  15. Nattestad A. Vedtofte P : Pitfalls in orthognathic model surgery. Int J Oral Maxillofac Surg 23 : 15, 1994
  16. Omura T, Glickman RS, Super S : Method to verify the accuracy of model surgery and prediction tracing. Int J Adult Orthod Orthognath Surg 11 : 271. 1996
  17. Polido WD, Ellis E, Sinn DP : An assessment of the predictability of maxillary repositioning. Int J Oral Maxillofac Surg 20 : 352, 1991
  18. Pretta FM, Caruso WA : The use of acrylic spacers in orthognathic model surgery. J Oral Maxillofac Surg 41 : 475, 1983 https://doi.org/10.1016/0278-2391(83)90137-4
  19. Schwestka R. Engelke D, Zimmer B et al : Positioning control of the upper incisors in orthognathic surgery. Eur J Orthod 13 : 371, 1991
  20. Van Sickels JE, Larsen AJ, Tripplett RG : Predictability of maxillary surgery : a comparison of internal and external reference marks. Oral surg Oral med Oral pathol 61 : 545, 1986
  21. Wylie GA. Epker BN, Mossop J : A technique to improve the accuracy of total maxillay surgery. Int J Orthod Orthognath Surg 3 : 147, 1988
  22. Kim SY, Lee EW : Study on the prepoperative prediction values and the postoperative actual values of the osteotomized segments in orthognathic surgery. J Kor Oral Maxillofac Surg 22(2) : 250, 1996
  23. Choi SW, Park HS, Cha IH : A study on accuracy of the maxillary repostioning in orthognathic surgery by the external measuring thchnique. J Kor Oral Maxillofac Surg 22(4) : 543, 1996
  24. Lee SH, Lee SH, Ju HH et al : The accuracy of measurements during model surgery for orthognathic planning. J Kor Oral Maxillofac Surg 27(1) : 45, 2001
  25. Han JH : Comparison of measurements in three dimensional digital model and dental plaster model. Yonsei University Graduate School. 2004