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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558

Abstract

BRUNSO, Joan et al. Customised guides and mini-plates: a guided-protocol for orthognathic surgery. Rev Esp Cirug Oral y Maxilofac [online]. 2017, vol.39, n.1, pp.7-14. ISSN 2173-9161.  http://dx.doi.org/10.1016/j.maxilo.2016.05.001.

Introduction:

Technological advances in preoperative planning and 3D printing allow custom-made biomedical devices to be synthesised using a completely digital workflow. The aim of this paper is to present and critically evaluate a new Orthognathic Positioning System (OPS) for Orthognathic Surgery. The OPS used bone-supported guides and a custom mini-plate to allow maxillary fragment positioning and fixation without the need for an inter-maxillary occlusal splint.

Materials and methods:

A prospective observational study was conducted on 10 cases of bimaxillary surgery using an inverse planning protocol. The guide and the custom-made mini-plate were designed using CAD-CAM software and synthesised by laser from commercially pure titanium powder. Accuracy was evaluated by overlap comparison of the virtual planning and 1-month postoperative CT scan. Operation times, complications, and overall safety profile were analysed.

Results:

The OPS was successfully applied to all cases, and was well tolerated. Operation times were reduced by avoiding inter-maxillary fixation, mini-plate bending, and obviating the need for intra-operative measurements. A mean postoperative accuracy of 1 mm was obtained in 68.1% of cases.

Conclusions:

The positioning systems for orthognathic surgery that involve custom made systems of osteosynthesis, can be a future option that could increase accuracy and the safety of the procedure, as well as the surgical times. We believe this novel technology is a step forward in optimising and improving the delivery of orthognathic surgery care.

Keywords : Orthognathic surgery; CAD-CAM; Computer-aided design; Guided surgery; Digital Planning; Sleep Apnoea.

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