Can electromagnetic-navigated maxillary positioning replace occlusional splints in orthognathic surgery? A clinical pilot study

Publication date: Available online 10 August 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Moritz Berger, Igor Nova, Sebastian Kallus, Oliver Ristow, Christian Freudlsperger, Urs Eisenmann, Hartmut Dickhaus, Michael Engel, Jürgen Hoffmann, Robin Seeberger
IntroductionBecause of the inaccuracy of intermaxillary splints in orthognathic surgery, intraoperative guidance via a real time navigation system might represent a suitable method for enhancing the precision of maxillary positioning. Therefore, in this clinical trial, maxillary repositioning after Le Fort I osteotomy was guided splintless by an electromagnetic navigation system.Materials and MethodsConservatively planned maxillary reposition in each of 5 patients was transferred to a novel software module of the electromagnetic navigation system. Intraoperatively, after Le Fort I osteotomy, the software guided the maxilla to the targeted position. Accuracy was evaluated by pre- and postoperative cone beam computer tomography imaging (the vectorial distance of the incisal marker points was measured in three dimensions) and compared with that of a splint transposed control group.ResultsThe repositioning of the maxilla guided by the electromagnetic navigation system was intuitive and simple to accomplish. The achieved maxillary position with a deviation of 0.7mm on average to the planned position was equally accurate compared with that of the splint transposed control group of 0.5mm (p>0.05).DiscussionThe data of this clinical study display good accuracy for splintless electromagnetic-navigated maxillary positioning. Nevertheless, this method does not surpass the splint-encoded gold standard with regard to accuracy. Future investigations will be necessary to show the full potential of electromagnetic navigation in orthognathic surgery.



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