Application of digital orthognathic surgery in the correction of hemifacial microsomia
10.3760/cma.j.cn114453-20201127-00594
- VernacularTitle:数字化正颌外科技术在半侧颜面短小畸形矫治中的应用
- Author:
Qilong WAN
1
;
Jingjing TAN
;
Shuxuan WU
;
Feng LI
;
Xuewen YANG
;
Zubing LI
Author Information
1. 武汉大学口腔医院正颌与唇腭裂整形外科，武汉 430079
- Keywords:
Computer-aided design;
Orthognathic surgery;
Hemifacial microsomia;
Three-dimensional printing;
Surgical error
- From:
Chinese Journal of Plastic Surgery
2022;38(1):24-31
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effectiveness of digital orthognathic surgery in the surgical treatment of patients with hemifacial microsomia (HFM) and patients’ satisfaction.Methods:The clinical data of HFM patients admitted to the Department of Orthognathic & Cleft Lip and Palate Plastic Surgery, Hospital of Stomatology, Wuhan University, from January 2017 to May 2020 were retrospectively analyzed. The digital orthognathic surgery was used to design surgical protocols before surgery. The intermediate wafer and terminal wafer by three-dimensional printing were applied to determine the position of maxillary and mandible bone blocks. The distance change between landmarks in maxillary and chin and the reference planes was measured. The skull CT and face photographs were taken 5 days after surgery to compare the distance between the actual position and the designed position. Data were expressed as the Mean±SD and analyzed by the pairing t-test with P<0.05 considered statistically. The patients’ satisfaction was investigated by interval scale method on day 7 and 6 months after operation. Results:There were 9 HFM patients in this study, included 5 men and 4 women, and the average age was 25.8±3.8 years old. 6 patients were affected on the left side and 3 patients was affected on the right side. All the operations were processed successfully. The wafers were in good position that the maxillary and mandible blocks were moved precisely according to the digital design. There were no accidental fractures of the jaw during the operation. The post-operative photographs and CT showed the stomatognathic system recovered well without serious postoperative complications. The errors between postoperative situation and preoperative designed situation in maxillary and chin were no statistically difference ( P>0.05). The maximum movement error of the maxillary bone block was the mark point of the first molar on the left, with an average error of (0.92 ± 0.34) mm. The patients’ satisfaction scores were averaged 83.2±2.7 points on day 7 after surgery, while the score dropped to 73.8±2.5 points after 6 months. Conclusions:The digital orthognathic surgery technology can satisfy the accuracy requirement of the surgical plan design for HFM patients in correcting the deflect of dental middle line, occlusal plane and chin point. High postoperative satisfaction can be achieved, which may decrease slightly 6 months after operation.
