Accuracy of 3D virtual surgical planning for maxillary positioning and orientation in orthognathic surgery

TLDR

The study retrospectively assessed the accuracy of 3‑D virtual surgical planning for maxillary positioning in 70 patients undergoing bimaxillary orthognathic surgery by comparing planned and postoperative outcomes. The authors compared pre‑operative VSP with postoperative CBCT scans using six linear and angular measurements, defining accuracy as mean differences <2 mm and <4°, and analyzed the data with a linear mixed model. The comparison revealed no significant differences; all measurements fell within clinically irrelevant limits (<2 mm, <1°), indicating that 3‑D VSP achieved high accuracy.

Abstract

This retrospective and observational study evaluated the accuracy of a 3D virtual surgical planning (VSP) for the maxillary positioning and orientation in patients undergoing bimaxillary orthognathic surgery, comparing the planned and postoperative outcomes.Seventy consecutive patients of both sexes, who were submitted to bimaxillary orthognathic surgery between 2015 and 2019 were included in our study.The patients were evaluated by fusing preoperative planning and postoperative outcome using cone-beam computed tomography scan evaluation. Three-dimensional VSP and postoperative outcomes were compared by using three linear and three angular measurements. The main outcome interest was the difference between the VSP movement, and the surgical movement obtained. The success criterion adopted was a mean linear difference of <2 mm and a mean angular difference of <4°.Results were analysed using a linear mixed model with fixed and random effects, at α = .05. No significant statistical differences were found for linear and angular measurements between the planned and postsurgical outcomes (P > .05). All overlapping points presented values within the range considered clinically irrelevant (<2 mm; <1°).Three-dimensional VSP was executed with a high degree of accuracy. When comparing the planned and postsurgical outcomes, all overlapping points presented values within the range considered clinically irrelevant.