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Accurate transfer of bimaxillary orthognathic surgical plans using computer-aided intraoperative navigation

  • Chen, Chen (Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University) ;
  • Sun, Ningning (Department of Emergency Intensive Care Unit, The Affiliated Hospital of Qingdao University) ;
  • Jiang, Chunmiao (Department of Orthodontics, The Affiliated Hospital of Qingdao University) ;
  • Liu, Yanshan (Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University) ;
  • Sun, Jian (Department of Oral and Maxillofacial Surgery, The Affiliated Hospital of Qingdao University)
  • Received : 2020.10.27
  • Accepted : 2021.02.15
  • Published : 2021.09.25

Abstract

Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Real-time Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.

Keywords

References

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