Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Three-Dimensional Evaluation of Skeletal Stability following Surgery-First Orthognathic Approach: Validation of a Simple and Effective Method

  • Nabil M. Mansour (Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University) ;
  • Mohamed E. Abdelshaheed (Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University) ;
  • Ahmed H. El-Sabbagh (Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University) ;
  • Ahmed M. Bahaa El-Din (Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University) ;
  • Young Chul Kim (Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center) ;
  • Jong-Woo Choi (Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center)
  • Received : 2022.10.14
  • Accepted : 2023.03.03
  • Published : 2023.05.15
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Abstract

Background The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.

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References

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