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On SW, Cho SW, Park SY, Yi SM, Park IY, Byun SH, Kim JC, Yang BE. Advancements in computer-assisted orthognathic surgery: A comprehensive review and clinical application in South Korea. J Dent 2024; 146:105061. [PMID: 38729289 DOI: 10.1016/j.jdent.2024.105061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 05/08/2024] [Accepted: 05/08/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES Orthognathic surgery (OS) has evolved with technological advancements, notably through the implementation of computer-assisted orthognathic surgery (CAOS). This article aims to elucidate various types of CAOS and their efficiency and accuracy, supplemented by a thorough literature review focusing on their clinical applications in South Korea. STUDY SELECTION, DATA, AND SOURCES A comprehensive search strategy was employed, including systematic reviews, meta-analyses, randomized controlled trials, and observational studies published until December 2023 in the PubMed, MEDLINE, and Google Scholar databases. The literature search was limited to articles written in English. RESULTS Static CAOS demonstrated high precision, reduced operative time, and high accuracy, suggesting its potential reliability in orthognathic procedures. Dynamic CAOS presented a promising avenue for exploration, showing an accuracy comparable to that of traditional methods. The critical considerations for CAOS include accuracy, time efficiency, and cost-effectiveness. Recent studies have indicated advancements in the time efficiency of static CAOS. Static CAOS requires less equipment and is more cost-effective than dynamic CAOS. CONCLUSIONS CAOS offers clear advantages over conventional OS in terms of surgical convenience and accuracy in implementing the surgical plan. To achieve recognition as the gold standard method for maxillofacial deformity treatment, CAOS must overcome its limitations and undergo continuous verification via well-designed studies. CLINICAL SIGNIFICANCE The introduction of CAOS, mainly static CAOS with high precision and reduced surgical time, signifies a notable advancement in OS. However, rigorous studies are warranted to validate CAOS as the gold standard for treating maxillofacial deformities.
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Affiliation(s)
- Sung-Woon On
- Division of Oral and Maxillofacial Surgery, Department of Dentistry, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong 18450, South Korea; Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea
| | - Seoung-Won Cho
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea
| | - Sang-Yoon Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea; Dental Artificial Intelligence and Robotics R&D Center, Hallym University Medical Center, Anyang 14066, South Korea
| | - Sang-Min Yi
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea; Dental Artificial Intelligence and Robotics R&D Center, Hallym University Medical Center, Anyang 14066, South Korea
| | - In-Young Park
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Dental Artificial Intelligence and Robotics R&D Center, Hallym University Medical Center, Anyang 14066, South Korea; Department of Orthodontics, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea
| | - Soo-Hwan Byun
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea; Dental Artificial Intelligence and Robotics R&D Center, Hallym University Medical Center, Anyang 14066, South Korea
| | - Jong-Cheol Kim
- Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea; Daegu Mir Dental Hospital, Daegu 41940, South Korea
| | - Byoung-Eun Yang
- Department of Artificial Intelligence and Robotics in Dentistry, Graduated School of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Institute of Clinical Dentistry, Hallym University, Chuncheon 24252, South Korea; Department of Oral and Maxillofacial Surgery, Hallym University Sacred Heart Hospital, Anyang 14066, South Korea; Dental Artificial Intelligence and Robotics R&D Center, Hallym University Medical Center, Anyang 14066, South Korea.
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Ge H, Wang Y, Gao H, Sun X, Wu Y, Li J. The accuracy of virtual surgical planning assisted management for L-shaped reduction malarplasty: A retrospective study. J Craniomaxillofac Surg 2024; 52:363-368. [PMID: 38278743 DOI: 10.1016/j.jcms.2024.01.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 11/19/2023] [Accepted: 01/16/2024] [Indexed: 01/28/2024] Open
Abstract
This study aims to evaluate the accuracy of L-shaped reduction malarplasty with bone setback or resection on the zygoma and the mortice and tenon joint structure on the zygomatic arch under the guidance of virtual surgical planning (VSP). Adult patients with zygomatic protrusion or hypertrophy were enrolled and divided. L-shaped reduction malarplasty with or without bone resection and with the mortice and tenon joint structure on the zygomatic arch was conducted either by digital procedures comprising VSP and three-dimensional (3D) printing titanium templates (Group I) or by conventional methods (Group II). Positions of representative landmarks and superimposition models were analyzed by 3D cephalometry. Satisfaction rate and incidences of clinical complications were compared as well. Satisfactory reduction of zygomatic protrusion or hypertrophy was recognized among all 78 patients. Improved symmetry and great surgical accuracy were observed according to the cephalometry analyses. The bone segment movement of virtual plans and actual results in Group I were measured and showed no obvious difference for the inward movement (5.42 ± 0.98 mm vs. 5.33± 0.93 mm, P = 0.6906) and the sagittal overlap (4.77 ± 1.32 mm vs. 4.87± 1.21 mm, P = 0.7386) at the zygoma roots, along with the step length at the long-arm of the L-shaped osteotomy line (2.43 ± 1.11 mm vs. 2.39± 0.89 mm, P = 0.8665). The high resemblance between virtual plans and actual results was depicted via superimposition models. Meanwhile, a higher satisfaction rate (28 in 36, 78% vs. 20 in 42, 48%) and a lower incidence rate of complications (11 in 36, 31% vs. 21 in 42, 50%) were found in Group I. Within the limitations of the study it seems that the application of VSP in reduction malarplasty could significantly contribute to better surgical accuracy and reduced difficulties in the operation, which would be beneficial to patients with zygoma hypertrophy or prominence.
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Affiliation(s)
- Han Ge
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yumo Wang
- Suzhou Stomatological Hospital, Suzhou, 215031, Jiangsu, China
| | - Heyou Gao
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Xiaoshuang Sun
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Yifan Wu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China
| | - Jihua Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Center of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, Sichuan, China.
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He Y, Wang Y, Al-Watary MQH, Gao H, Li J, Wang Y. Three-dimensional analysis of zygomatic change after L-shaped reduction malarplasty with bone setback or resection. J Plast Reconstr Aesthet Surg 2023; 83:42-50. [PMID: 37270994 DOI: 10.1016/j.bjps.2023.04.060] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/06/2023] [Accepted: 04/11/2023] [Indexed: 06/06/2023]
Abstract
PURPOSE Reduction malarplasty is one of the most popular procedures for esthetic facial contouring in East Asians. The retrospective observational study aimed to analyze the association between the zygomatic change and bone setback or resection to propose quantitative guidance for L-shaped reduction malarplasty based on computed tomographic (CT) images. METHODS A retrospective observational study was conducted on patients who underwent L-shaped reduction malarplasty with bone resection (Group I) or without bone resection (Group II). The amount of bone setback and resection was calculated. The unilateral width changes of the anterior, middle, and posterior zygomatic regions as well as zygomatic protrusion change were also evaluated. Pearson correlation analysis and linear regression analysis were used to analyze the relationship between the bone setback or resection and the zygomatic changes. RESULTS Eighty patients who underwent L-shaped reduction malarplasty were included in this study. Significant correlation was observed between the bone setback or resection and the change of anterior, and middle zygomatic width as well as protrusion in both the two groups (P < .001). The correlation between bone setback or resection and the posterior zygomatic width change was not significant (P >.05). CONCLUSION The bone setback or resection of L-shaped reduction malarplasty lead to the anterior and middle zygomatic width and zygomatic protrusion changes. Furthermore, the linear regression equation can be referenced as a guidance for a preoperative surgical plan.
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Affiliation(s)
- Yingyou He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yumo Wang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China; Suzhou Stomatological Hospital, China
| | - Mohammed Qasem Hezam Al-Watary
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Heyou Gao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jihua Li
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic & TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
| | - Yu Wang
- Department of Oral and Maxillofacial Surgery, the Affiliated Stomatological Hospital of Guizhou Medical University, Guiyang, China.
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Park JC. Effects of surgical factors on the outcomes of zygoma reduction malarplasty: a quantitative computed tomography study. Maxillofac Plast Reconstr Surg 2023; 45:3. [PMID: 36617610 PMCID: PMC9826774 DOI: 10.1186/s40902-023-00371-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 12/30/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Malarplasty is widely performed for zygoma reduction. The effects of body segmentation, plate bending, and postoperative arch location on zygomatic movement have not been analyzed using computed tomography (CT). RESULTS We quantitatively analyzed the effects of surgical factors on zygomatic movements via superimposition of preoperative and postoperative CT images using three-dimensional software. Our results showed that segmentation had the most significant effect on the horizontal reduction of malar eminence (β = 0.593, r = 0.696, adjusted r2 = 0.479, F = 79.595; p < 0.001). In addition, upward and posterior arch movements had significant effects on the anterior and posterior movements of the eminence (β = - 0.379 for vertical arch movement, β = 0.324 for arch setback, r = 0.603, adjusted r2 = 0.352, F = 31.943; p < 0.001). The major factors that influenced inward arch movement at the coronoid process included segmentation and inward movement at the arch osteotomy site. To prevent interference of the coronoid process and arch, surgeons should pay attention to the degree of segmentation (β = 0.349) and inward movement at the arch osteotomy site (β = 0.494; r = 0.688, adjusted r2 = 0.464, F = 50.412; p < 0.001). CONCLUSIONS Surgical factors related to malarplasty affect the movement of specific parts of the zygoma. In addition, accurate application is possible by considering the anatomical structure of the application area when using the bending plate.
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Affiliation(s)
- Jong Chul Park
- Wonjin Dental Clinic, Pagoda Tower 1306 6 Seocho-dong Seocho-gu, Seoul, South Korea
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