Nys M, Bempt MVD, Shaheen E, Dormaar JT, Politis C. Three-dimensional planning accuracy and follow-up of Le Fort I osteotomy in cleft lip/palate patients.
JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023;
124:101421. [PMID:
36764580 DOI:
10.1016/j.jormas.2023.101421]
[Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 02/01/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
OBJECTIVES
Our aim was to determine the accuracy of the three-dimensional (3D) virtual planning and stability of LeFort I osteotomy in cleft lip and/or palate patients (CLP) using a validated 3D method.
MATERIALS AND METHODS
Eight patients with a history of cleft lip/palate treated with LeFort I osteotomy for maxillary hypoplasia between January 2016 and April 2020 were included in this retrospective study. Three-dimensional virtual planning was performed using Proplan software then transferred to the operation theater via 3D printed occlusal wafers. The accuracy of the 3D planning and the 1-year stability of the maxilla were evaluated by means of a validated semiautomatic stepwise module in Amira software resulting into 3 linear measurements: anterior/posterior, medial/lateral, superior/inferior and 3 rotational measurements: pitch, roll, yaw.
RESULTS
The largest mean absolute difference (MAD) for accuracy assessment was found in the A/P direction (2.75mm±2.25 mm) and in pitch (3.23°±2.11°). For A/P translation, an error of >2 mm was observed in 5(62.5%), for S/I translation an error of >2 mm was observed in 4(50.0%) of the 8 patients, whereas for pitch 3 patients(37,5%) showed an error >4° At one year follow-up, the largest linear and rotational MAD was found in the A/P direction (1.20mm±0.92 mm) and in pitch (3.31°±2.31°).
CONCLUSIONS
Findings of this study show that 3D virtual computer-assisted orthognathic surgery enables an accurate repositioning of the hypoplastic maxilla in CLP patients. However, A/P translations and pitch rotations remain challenging to achieve during surgery. These movements were also found to be least stable at one year follow-up.
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