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Abstract

AIM: Computer-aided craniofacial reconstructions have been developed to allow surgeons to accurately simulate and predict the surgical outcome on complicated 3-D craniofacial structures. We have developed a new computerized method of 3-D simulation and prediction in orthognathic surgery (CASPOS) that not only enables clinicians to plan and simulate the surgical procedures, but also provides a bony "guiding splint" to allow surgeons to precisely position the bony segments into the planned location. This study is aimed for assessing the accuracy of simulation and prediction of our CASPOS protocol. MATERIALS AND METHOD: Fifteen adult patients with severe dento-skeletal discrepancies treated with orthodontics and 2-jaw orthognathic surgery were selected. They were all managed with maxillary LeFort I osteotomy and mandibular bilateral sagittal split osteotomy. Post-surgical fixation lasted for 2 weeks. Pre-surgical CT scan was carried out 3-week before surgery after all the required orthodontic movement was completed. The surgical simulation and prediction were executed according to our CASPOS protocol. The surgical outcome was assessed by CT scan taken 6 months after surgery. The accuracy brought by CASPOS was evaluated by comparing the differences between prediction and post-surgical CT data. RESULT: The post-surgical profile of patients showed significant improvement. The surgical bony movements all complied with those of simulation in terms of magnitudes and directions. The outcome demonstrated the satisfactory result, and the means of geographical summation error in this study were within the range of ± 0.589 mm. CONCLUSION: The application of CASPOS protocol with pre-designed bony guiding splint in treating craniofacial patients in this study can grant surgeons to precisely manage the complicated skeletal deformities. Our CASPOS technique provides a novel approach for orthodontists and surgeons to accurately remedying the patients with complex craniofacial discrepancies.

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