Accuracy of Maxillary Repositioning Surgery in Teaching Hospitals Using Conventional Model Surgery Publisher



Yari A¹ ; Hasheminasab M² ; Badri A¹ ; Tanbakuchi B³ ; Fasih P⁴
Source: Oral and Maxillofacial Surgery Published:2023

Abstract

Purpose: The aim of this study was to assess the accuracy of maxillary repositioning surgery in teaching hospitals using conventional model surgery. Materials and methods: A total of 73 patients undergoing single-piece LeFort I osteotomies in the maxilla and bilateral sagittal split osteotomies in the mandible were included in the study. Preoperative and immediate postoperative cone-beam CT were compared in computer software (Dolphin3D©). Maxillary landmarks relative to the vertical and horizontal reference lines were evaluated. The difference between the planned and achieved maxillary positions was measured. Distance error in millimeters and achievement ratio (achieved displacement/planned displacement*100) were calculated for different maxillary movements. Results: Midline correction and advancement were the most accurate movements with an overall mean distance error of 0.53 mm and 0.63 mm respectively while posterior impaction and setback were the least accurate movements with 1.38 mm and 1.76 mm mean discrepancies, respectively. A significant difference was observed only in setback movement regarding the discrepancy value (P <.05). Although setback and down-graft movements tended to under-correction, all other movements were overcorrected. As the magnitude of maxillary movements increases, the accuracy decreases. In severe displacements (≥ 8 mm), the accuracy declines significantly (P <.05). Conclusion: Classic cast surgery and manually fabricated intermediate splints in teaching hospitals yield accurate and acceptable results in the majority of cases (84.6%). The accuracy of maxillary repositioning decreases as the magnitude of displacement increases. © 2023, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.