Maxilla-first patient-specific osteosynthesis vs mandible-first bimaxillary orthognathic surgery using splints: a randomized controlled trial: a randomized controlled trial
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| Titel: | Maxilla-first patient-specific osteosynthesis vs mandible-first bimaxillary orthognathic surgery using splints: a randomized controlled trial: a randomized controlled trial |
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| Autoren: | H. van der Wel, R.H. Schepers, F. Baan, F.K.L. Spijkervet, J. Jansma, J. Kraeima |
| Quelle: | International Journal of Oral and Maxillofacial Surgery, 54, 8, pp. 720-726 |
| Verlagsinformationen: | Elsevier BV, 2025. |
| Publikationsjahr: | 2025 |
| Schlagwörter: | Oral and Maxillofacial Surgery - Radboud University Medical Center, Three-dimensional imaging, Bone plates, Computer-aided design, Orthognathic surgery, Patient-specific computational modelling |
| Beschreibung: | Patient-specific osteosynthesis plates and three-dimensional virtual surgical planning with patient-specific surgical guides have significantly advanced orthognathic surgery, enhancing surgical accuracy. This study compares the outcomes of the mandible-first approach using an intermediate splint and manually bent osteosynthesis plates with the maxilla-first approach utilizing patient-specific osteosynthesis fixation in bimaxillary orthognathic surgery. This multi-centre randomized controlled trial included 88 patients, with 77 completing the study. Patients were randomly assigned to either the 'mandible-first' group (mandible-first with an intermediate splint) or the 'maxilla-first with PSO' group (maxilla-first with patient-specific osteosynthesis). Postoperative evaluation using cone beam computed tomography images showed significantly lower deviations from the preoperative plan in the maxilla-first with PSO group compared to the mandible-first group, for anteroposterior (median 1.0 mm vs 1.8 mm, P = 0.008) and left/right translations (median 0.4 mm vs 0.8 mm, P = 0.003), and yaw rotation (median 0.5° vs 1.0°, P = 0.013). Regarding clinical accuracy (categorized as optimal, good, or suboptimal), 59.5% of the patients in the maxilla-first with PSO group had an optimal or good result compared to 17.5% in the mandible-first group. The study findings suggest the maxilla-first PSO approach offers enhanced accuracy, supporting its adoption in orthognathic surgery for better surgical outcomes. |
| Publikationsart: | Article |
| Sprache: | English |
| ISSN: | 0901-5027 |
| DOI: | 10.1016/j.ijom.2025.01.016 |
| Zugangs-URL: | https://hdl.handle.net/2066/320717 https://repository.ubn.ru.nl//bitstream/handle/2066/320717/320717.pdf |
| Rights: | CC BY |
| Dokumentencode: | edsair.doi.dedup.....f84ee880bfbf2bca199e82c756711fd5 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Patient-specific osteosynthesis plates and three-dimensional virtual surgical planning with patient-specific surgical guides have significantly advanced orthognathic surgery, enhancing surgical accuracy. This study compares the outcomes of the mandible-first approach using an intermediate splint and manually bent osteosynthesis plates with the maxilla-first approach utilizing patient-specific osteosynthesis fixation in bimaxillary orthognathic surgery. This multi-centre randomized controlled trial included 88 patients, with 77 completing the study. Patients were randomly assigned to either the 'mandible-first' group (mandible-first with an intermediate splint) or the 'maxilla-first with PSO' group (maxilla-first with patient-specific osteosynthesis). Postoperative evaluation using cone beam computed tomography images showed significantly lower deviations from the preoperative plan in the maxilla-first with PSO group compared to the mandible-first group, for anteroposterior (median 1.0 mm vs 1.8 mm, P = 0.008) and left/right translations (median 0.4 mm vs 0.8 mm, P = 0.003), and yaw rotation (median 0.5° vs 1.0°, P = 0.013). Regarding clinical accuracy (categorized as optimal, good, or suboptimal), 59.5% of the patients in the maxilla-first with PSO group had an optimal or good result compared to 17.5% in the mandible-first group. The study findings suggest the maxilla-first PSO approach offers enhanced accuracy, supporting its adoption in orthognathic surgery for better surgical outcomes. |
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| ISSN: | 09015027 |
| DOI: | 10.1016/j.ijom.2025.01.016 |