4.3 Article

Splintless orthognathic surgery in edentulous patients-a pilot study

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CHURCHILL LIVINGSTONE
DOI: 10.1016/j.ijom.2019.08.022

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Splintless orthognathic; maxillo-mandibular advancement osteotomy; Le Fort I osteotomy; Bilateral sagittal split osteotomy; Edentulous

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The aim of this pilot study was to evaluate the accuracy and predictability of a splintless treatment protocol for edentulous patients undergoing orthognathic surgery in four consecutive cases. All operations were virtually planned, followed by computer-aided design of individual osteotomy guides and patient-specific fixation implants, which were three-dimensionally printed in titanium. In order to evaluate the discrepancy between the planned and the achieved postoperative result, the postoperative outcome was compared to the virtual treatment plan. Rotational and translational movement and discrepancies with the planned movements were quantified for the maxilla; the advancement was quantified for the mandible. For the maxilla, there was a mean translation discrepancy of 0.6 mm. With regard to rotation, there was a mean discrepancy of 1.9 degrees, 0.1 degrees, and 0.4 degrees for pitch, yaw, and roll, respectively. The mean discrepancy in translation of the mandible was 0.4 mm. The results of this pilot study indicate that the splintless treatment protocol for orthognathic surgery in edentulous patients presented here is accurate and predictable.

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