The use of patient-specific implants in orthognatic surgery: A series of 30 mandible sagittal split osteotomy patients

Publication date: Available online 3 March 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Juho Suojanen, Junnu Leikola, Patricia Stoor
PurposeVirtual surgery combined with patient-specific saw and drill guides and osteosynthesis materials are rapidly spreading from reconstructive surgery to orthognatic surgery. Most commercial partners are already providing computer-aided design and computer-aided manufacture (CAD/CAM) wafers and patient-specific saw guides. Clear benefits have been demonstrated for custom-made drill guides combined with individually designed three-dimensional (3D) printed patient-specific implants (PSI) as a reposition and fixation system in Le Fort I osteotomy.Materials and MethodsWe treated 30 patients who underwent bilateral sagittal split osteotomy (BSSO) due to class II dento-skeletal deformities with the additional use of drill guides combined with PSI as a fixation and positioning system.ResultsThe PSIs fitted bilaterally with total precision in 11 of the 30 patients. In 17 patients, the PSIs were used with some modifications. In 2 of 30 patients, the PSIs could not be used as a fixation due to misfit.ConclusionDue to unpredictable fitting, the use of PSIs with drill guides alone in BSSO without wafers cannot be recommended. Further studies are needed to evaluate the interfering parts, which seem to be related to condylar positioning and bony interferences at the osteotomy sites.



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