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. 2022 Jul 15;12(7):1147.
doi: 10.3390/jpm12071147.

The Predictability of the Surgical Outcomes of Class III Patients in the Transverse Dimension-A Study of Three-Dimensional Assessment

U-Kei Lai  1 , Cheng-Chun Wu  2 , Yu-Jen Chang  1 , Shiu-Shiung Lin  1 , Jui-Pin Lai  2 , Te-Ju Wu  1
Affiliations

The Predictability of the Surgical Outcomes of Class III Patients in the Transverse Dimension-A Study of Three-Dimensional Assessment

U-Kei Lai et al. J Pers Med. .

Abstract

This study aimed to assess the outcomes of planned maxillary surgical movements in the transverse direction in patients possessing a Class III skeletal pattern. The available consecutive patients' records were retrospectively reviewed. Only those possessing a Class III skeletal pattern, and for whom the same virtual planning system was used, were enrolled. The waferless technique was used to guide the jawbone repositioning. A representative triangle in the virtual maxilla of each stage was used to validate the planned surgical movements (PSMs) and the outcome discrepancy (OD). The linear and angular measurements were retrieved for the assessments of the correlation between PSM and OD. In total, 44 adult patients who met the inclusion criteria were studied. The average linear OD of the A-point in the transverse direction was 0.66 ± 0.54 mm, and the yaw correction showed 1.02 ± 0.84 degrees in difference. There was no specific correlation between the linear PSMs and ODs; however, the angular ones were positively correlated. With the help of the waferless technique to transfer the virtual planning results, the practitioners could confidently predict the postsurgical maxillary position in the transverse direction in the orthognathic surgery of Class III patients. However, the yaw correction should be carefully planned to avoid postsurgical instabilities.

Keywords: Angle Class III; malocclusion; orthognathic surgery; prognathism.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(a) The 3D-printed surgical guides recorded the orientation and thickness of the surgical cuts. The screw holes over the surgical guides also served to guide the placement of the prebent fixation plates after jawbone repositioning. (b) The guidance plates were accurately affixed onto the maxillary surface to provide cutting guidance.
Figure 2
Figure 2
The intraoperative fixation plates were prebent on a 3D-printed stereolithographic model of actual anatomical size. The precise matching of the screw holes and fixation plates provided guidance for the intraoperative jawbone repositioning and orientation.
Figure 3
Figure 3
The illustration of the processing procedures, including virtual planning and outcome assessments: A representative triangle was incorporated into the maxilla and transferred into different stages by registering it at the area of the posterior nasal spine. The representative triangle at the simulation stage (pink) served as the reference plane. The planned surgical movements were calculated by overlapping the initial triangle (blue) onto the reference plane. On the other hand, the outcome discrepancy was measured by the differences between the outcome triangle (green) and the simulation triangle.
See this image and copyright information in PMC

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