Enhance Surgical Outcomes in Patients with Skeletal Class III Facial Asymmetry by 3D Surgical Simulation

Publication date: Available online 19 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Ellen Wen-Ching Ko, Cheng-Hui Lin, Ying-An Chen, Yu-Ray Chen
PurposeWith the advance of the image fusion techniques, the creation of the 3D virtual head and 3D surgical simulations provided previews of the surgical procedures. The aim of the study was to investigate the surgical outcomes in patients receiving orthognathic surgery (OGS) with the guidance of 3D computer-assisted surgical simulation.MethodsThe study included 34 consecutive patients (15 men and 19 women, 18.1–33.0 years of age) with skeletal Class III facial asymmetry who had bimaxillary OGS. The 1-week postoperative cone-beam computed tomography craniofacial images (Ta) were constructed and superimposed on preoperative simulated virtual images (Ts) at the cranial base and surfaces of the frontal and periorbital regions. The 3D cephalometric landmarks were measured relative to three reference planes. The outcomes among different experience level of surgeons were also compared.ResultsAlthough the means of Ta−Ts were small, statistical differences were observed in center of maxillary and mandibular incisors and B point relative to the midline, and in the maxillary first molar in vertical distances, sagittal dental–skeletal dimensions, and pitch angles. The root mean square deviation (RMSDL) of measurement variables relative to the center landmark accuracy was 1.5 mm and <2 mm at the maxilla and mandible, respectively. RMSDL >2 mm were located at the maxillary first molar in the vertical distance and in the sagittal dimension at points ANS and B point. Variables related to centering the midline structures were highly interrelated. The roll angle deviation was associated with centering the midline landmarks. The yaw angle deviation was not associated with midline correction.ConclusionWith guidance from 3D surgical simulation, surgeons were able to achieve similar outcomes to correct facial asymmetry regardless of their years of practice.



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