Vol. 2 No. 1 (2019): Current Issue
Research Article

The Role of Virtual Surgical Planning in Increasing the Predictability in Orthognathic Surgery

Quereshy FA
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Baur DA
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Levintov N
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Nguyen JL
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
DeLeonibus MA
Dental Student, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Demko C
Department of Community Dentistry, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Bazina M
Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Valiathan M
Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH, USA
Published March 30, 2019
Keywords
  • Orthognathic Surgery,
  • Virtual surgical planning,
  • Computer-assisted surgery,
  • Three-dimensional imaging

Abstract

Purpose: To evaluate our surgical outcomes by comparing our surgical plan to the outcome of the surgery and evaluate our efficacy using Virtual Surgical Planning and Medical Modeling software. Our aim is to determine the quality and validity of Virtual Surgical Planning when comparing pre-surgical plans with post-surgical outcomes. 
Patients and Methods: A cohort study was conducted for patients who underwent orthognathic surgery at a single institution.  Utilizing virtual plans and models, select points for the virtual plans were compared and superimposed with that of the actual surgical movements.  The primary predictor variable were the pre-surgical virtual plans of movements; the outcome variable consisted of the actual post-surgical movements.  Statistical analysis was computed via IBM SPSS Version 25 software utilizing a paired t-test assuming equal variance with alpha (p<0.05). The sample of patients included those who had pre-operative and post-operative cone beam computed tomography scans, a virtual surgical plan, CAD/CAM splints, and LeFort I osteotomy and bilateral sagittal split osteotomy.
Results: The study consisted of ten patients between the ages of 18-51 years old. Pre and post surgical plans were superimposed and four points of measurement were compared along 3 dimensional planes. There were no statistical significant associations between the virtually planned and post surgical planned values.
Conclusion: Our results suggest that the use of virtual surgical planning in orthognathic surgery yields favorable and accurate surgical outcomes regarding rotational movements with minor degrees of discrepancies.