Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning.
Current Status of Surgical Planning for Orthognathic Surgery: Traditional Methods versus 3D Surgical Planning.
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DOI：
10.1097/gox.0000000000000184
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发表时间：
2015-02
期刊：
影响因子：
--
通讯作者：
Urata MM
中科院分区：
文献类型：
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作者：
Hammoudeh JA;Howell LK;Boutros S;Scott MA;Urata MM
传统上使用石模手术进行颌外科手术。这涉及将上颌骨和下颌骨的所需临床运动转换成石模型，然后将石模型切割并重新定位成I类咬合，从I类咬合生成夹板。模型手术是一种精确的和可重复的方法，手术矫正的牙面骨骼的腭裂和非腭裂患者，虽然相当耗时。随着计算机断层扫描的出现，3D成像和虚拟手术计划（VSP）在正颌外科中站稳了脚跟，VSP在国内和世界许多地方迅速取代了传统的模型手术。目前尚待确定的是，虚拟模型手术的应用和可行性是否达到了一个点，即它将消除私人和学术环境中对传统模型手术的需求。比较传统的模型手术与VSP夹板制作，以确定在我们机构的正颌外科中使用的可行性和应用的准确性。VSP被发现在一小部分时间内产生与模拟手术夹板相同质量的丙烯酸夹板。VSP夹板制造的缺点是增加的生产成本和某些限制，因为它涉及复杂的颅面患者。我们认为，虚拟模型手术将取代和取代传统的模型手术，因为它将成为成本和时间效益的私人和学术设置的从业者提供正颌外科治疗的腭裂和非腭裂患者。
Orthognathic surgery has traditionally been performed using stone model surgery. This involves translating desired clinical movements of the maxilla and mandible into stone models that are then cut and repositioned into class I occlusion from which a splint is generated. Model surgery is an accurate and reproducible method of surgical correction of the dentofacial skeleton in cleft and noncleft patients, albeit considerably time-consuming. With the advent of computed tomography scanning, 3D imaging and virtual surgical planning (VSP) have gained a foothold in orthognathic surgery with VSP rapidly replacing traditional model surgery in many parts of the country and the world. What has yet to be determined is whether the application and feasibility of virtual model surgery is at a point where it will eliminate the need for traditional model surgery in both the private and academic setting. Traditional model surgery was compared with VSP splint fabrication to determine the feasibility of use and accuracy of application in orthognathic surgery within our institution. VSP was found to generate acrylic splints of equal quality to model surgery splints in a fraction of the time. Drawbacks of VSP splint fabrication are the increased cost of production and certain limitations as it relates to complex craniofacial patients. It is our opinion that virtual model surgery will displace and replace traditional model surgery as it will become cost and time effective in both the private and academic setting for practitioners providing orthognathic surgical care in cleft and noncleft patients.