Systematic three-dimensional analysis of wafer-based maxillary repositioning procedures in orthognathic surgery

Publication date: Available online 31 August 2017
Source:Journal of Cranio-Maxillofacial Surgery
Author(s): Timo Dreiseidler, Max-Philipp Lentzen, Matthias Zirk, Ali-Farid Safi, Joachim E. Zoeller, Matthias Kreppel
PurposeLittle is known about the three-dimensional (3D) transfer accuracy in maxillary repositioning procedures based on conventionally manufactured dental-mounted wafers. The purpose of the present study was a systematic 3D analysis for wafer-based maxillary positioning in orthognathic surgery.Materials and MethodsA total of 92 patients underwent Le Fort I in addition to mandibular bilateral sagittal split osteotomies (BSSO). Alignment of the pre- and postsurgical CBCT data sets allowed measuring maxillary position changes in axial, sagittal and transversal directions.ResultsThe highest achieved absolute transfer inaccuracies were 1.37 mm, ± 0.84 in the sagittal direction, followed by 1.15 mm, ± 0.69 in the axial, as well as 1.05 mm, ± 0.79 in the transversal direction. The largest relative deviations could be found for repositions in the transversal plane (109.4%, ± 4.5), followed by the axial (66.2%, ± 51.5) and sagittal plane (49.3%, ± 2.2). Significant transfer accuracy differences of repositioning procedures in the sagittal direction, mainly advancement procedures, could be detected if performed with (1.75 mm, ± 0.90) or without (1.18 mm, ± 0.78) additional rotational correction component. No significant differences were found between unidirectional and multidirectional maxillary correction procedures.ConclusionThe present study for the first time delivers systematic 3D accuracy data of wafer-based maxillary positioning procedures, attesting to its feasibility but also further encouraging the search for improvement strategies.



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