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Treatment outcome in orthognathic surgery-A prospective randomized blinded case-controlled comparison of planning accuracy in computer-assisted two- and three-dimensional planning techniques (part II)

Journal article
Authors Martin Bengtsson
G. Wall
L. Greiff
Lars Rasmusson
Published in Journal of Cranio-Maxillofacial Surgery
Volume 45
Issue 9
Pages 1419-1424
ISSN 1010-5182
Publication year 2017
Published at Institute of Odontology
Pages 1419-1424
Language en
Links doi.org/10.1016/j.jcms.2017.07.001
Keywords Orthognathic surgery, Dentofacial deformity, Computer-aided surgical simulation, Virtual surgical planning, Cephalometry, Randomized controlled trial, cad/cam surgical splints, distraction osteogenesis, simulation, prediction, maxillary, soft, Dentistry, Oral Surgery & Medicine, Surgery
Subject categories Surgery

Abstract

Purpose: The aim of the present study was to compare the accuracy of two-dimensional (2D) and three-dimensional (3D) prediction methods. The hypothesis was that a 3D technique would give a more accurate outcome of the postoperative result. Material and methods: Patients with severe class III occlusion were included and planed with both a 2D and 3D prediction technique. They were there after randomly subdivided into a control (2D) and test (3D) group and treated according to the technique randomized for. Cephalometric measurements from 2D and 3D predictions were compared with 12-month follow-up respectively. Together with an analysis of tracing error, placements of 3580 cephalometric markers, 2460 measurements, 680 intra-individual analyses and 1200 preop/postop comparisons were performed in 57 individuals. Results: Statistically significant differences for accuracy between the two groups were seen for 11/NSL112/NSL2 and for A-A2 (p < 0.05). Both groups showed a high level of accuracy for SNA and SNB. The test group also showed a relatively high level of accuracy for 11/NSL and for the A-point. No prediction method achieves a perfect accuracy. As expected from this, measuring accuracy within each group showed statistically significant difference for all markers and cephalometric measurements (p < 0.001). Mandibular markers showed greater differences than maxillary markers. Conclusion: The present study indicates an equal high accuracy in predicting facial outcome for both studied techniques. However, in patients with asymmetry the three-dimensional technique has an obvious advantage. (C) 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

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