Maxilla-first patient-specific osteosynthesis vs mandible-first bimaxillary orthognathic surgery using splints: a randomized controlled trial

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...

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Published in:	International journal of oral and maxillofacial surgery Vol. 54; no. 8; pp. 720 - 726
Main Authors:	van der Wel, H., Schepers, R.H., Baan, F., Spijkervet, F.K.L., Jansma, J., Kraeima, J.
Format:	Journal Article
Language:	English
Published:	Denmark Elsevier Inc 01.08.2025
Subjects:	Adolescent Adult Bone Plates Computer-aided design Cone-Beam Computed Tomography Female Humans Imaging, Three-Dimensional Male Mandible - surgery Maxilla - surgery Oral and Maxillofacial Surgery Orthognathic surgery Orthognathic Surgical Procedures - instrumentation Orthognathic Surgical Procedures - methods Patient-specific computational modelling Splints Surgery, Computer-Assisted - methods Three-dimensional imaging Treatment Outcome Orthognathic surgery Bone plates Computer-aided design Patient-specific computational modelling Three-dimensional imaging
ISSN:	0901-5027, 1399-0020, 1399-0020
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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.
AbstractList	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. 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.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. AbstractPatient-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.
Author	Kraeima, J. Schepers, R.H. Baan, F. Jansma, J. van der Wel, H. Spijkervet, F.K.L.
Author_xml	– sequence: 1 givenname: H. surname: van der Wel fullname: van der Wel, H. email: h.van.der.wel@umcg.nl organization: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands – sequence: 2 givenname: R.H. surname: Schepers fullname: Schepers, R.H. organization: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands – sequence: 3 givenname: F. orcidid: 0000-0002-3626-656X surname: Baan fullname: Baan, F. organization: Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, the Netherlands – sequence: 4 givenname: F.K.L. surname: Spijkervet fullname: Spijkervet, F.K.L. organization: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands – sequence: 5 givenname: J. orcidid: 0000-0003-2536-4786 surname: Jansma fullname: Jansma, J. organization: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands – sequence: 6 givenname: J. surname: Kraeima fullname: Kraeima, J. organization: Department of Oral and Maxillofacial Surgery, University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
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References	Harris, Taylor, Thielke, Payne, Gonzalez, Conde (bib10) 2009; 42 Kraeima, Schepers, Spijkervet, Maal, Baan, Witjes, Jansma (bib3) 2020; 49 Williams, Walker, Hughes, Goodson, Mustafa (bib20) 2022; 60 Diaconu, Holte, Berg-Beckhoff, Pinholt (bib6) 2023; 13 Stokbro, Liebregts, Baan, Bell, Maal, Thygesen, Xi (bib9) 2019; 77 Marchetti, Bianchi, Bassi, Gori, Lamberti, Sarti (bib14) 2007; 18 Heufelder, Wilde, Pietzka, Mascha, Winter, Schramm, Rana (bib1) 2017; 45 Liebregts, Baan, De Koning, Ongkosuwito, Bergé, Maal, Xi (bib8) 2017; 7 Jones, Amarista, Jeske, Szalay, Ellis (bib17) 2022; 80 Stokbro, Aagaard, Torkov, Bell, Thygesen (bib15) 2014; 43 Sun, Fallah (bib19) 2022; 26 Baan, Sabelis, Schreurs, Van De Steeg, Xi, Van Riet, Becking, Maal (bib13) 2021; 16 Proffit, Turvey, Phillips (bib16) 2007; 3 Li, Wei, Jiang, Qian, Zhang, Yu, Zhang, Wang (bib4) 2021; 148 Wong, Goonewardene, Allan, Mian, Rea (bib18) 2021; 50 Borba, Borges, Cé, Venturi, Naclério-Homem, Miloro (bib7) 2016; 45 Hanafy, Akoush, Abou-ElFetouh, Mounir (bib5) 2020; 49 Baan, Liebregts, Xi, Schreurs, De Koning, Bergé, Maal (bib12) 2016; 11 Li, Shen, Jiang, Li, Jiang, Xia, Shen, Wang (bib2) 2017; 46 Gaber, Shaheen, Falter, Araya, Politis, Swennen, Jacobs (bib11) 2017; 75 Baan (10.1016/j.ijom.2025.01.016_bib13) 2021; 16 Williams (10.1016/j.ijom.2025.01.016_bib20) 2022; 60 Heufelder (10.1016/j.ijom.2025.01.016_bib1) 2017; 45 Liebregts (10.1016/j.ijom.2025.01.016_bib8) 2017; 7 Gaber (10.1016/j.ijom.2025.01.016_bib11) 2017; 75 Kraeima (10.1016/j.ijom.2025.01.016_bib3) 2020; 49 Harris (10.1016/j.ijom.2025.01.016_bib10) 2009; 42 Marchetti (10.1016/j.ijom.2025.01.016_bib14) 2007; 18 Jones (10.1016/j.ijom.2025.01.016_bib17) 2022; 80 Stokbro (10.1016/j.ijom.2025.01.016_bib9) 2019; 77 Proffit (10.1016/j.ijom.2025.01.016_bib16) 2007; 3 Wong (10.1016/j.ijom.2025.01.016_bib18) 2021; 50 Borba (10.1016/j.ijom.2025.01.016_bib7) 2016; 45 Stokbro (10.1016/j.ijom.2025.01.016_bib15) 2014; 43 Baan (10.1016/j.ijom.2025.01.016_bib12) 2016; 11 Diaconu (10.1016/j.ijom.2025.01.016_bib6) 2023; 13 Sun (10.1016/j.ijom.2025.01.016_bib19) 2022; 26 Li (10.1016/j.ijom.2025.01.016_bib2) 2017; 46 Hanafy (10.1016/j.ijom.2025.01.016_bib5) 2020; 49 Li (10.1016/j.ijom.2025.01.016_bib4) 2021; 148
References_xml	– volume: 77 start-page: 1882 year: 2019 end-page: 1893 ident: bib9 article-title: Does mandible-first sequencing increase maxillary surgical accuracy in bimaxillary procedures? publication-title: J Oral Maxillofac Surg – volume: 46 start-page: 1298 year: 2017 end-page: 1305 ident: bib2 article-title: A new approach of splint-less orthognathic surgery using a personalized orthognathic surgical guide system: a preliminary study publication-title: Int J Oral Maxillofac Surg – volume: 26 start-page: 137 year: 2022 end-page: 142 ident: bib19 article-title: Efficacy and cost of maxillary patient-specific implants in orthognathic surgery: a review of three patient cases publication-title: Perm J – volume: 60 start-page: 537 year: 2022 end-page: 546 ident: bib20 article-title: Accuracy and cost effectiveness of a waferless osteotomy approach, using patient specific guides and plates in orthognathic surgery: a systematic review publication-title: Br J Oral Maxillofac Surg – volume: 13 start-page: 125 year: 2023 ident: bib6 article-title: Three-dimensional accuracy and stability of personalized implants in orthognathic surgery: a systematic review and a meta-analysis publication-title: J Pers Med – volume: 80 start-page: 827 year: 2022 end-page: 837 ident: bib17 article-title: Comparison of the accuracy of maxillary positioning with interim splints versus patient-specific guides and plates in executing a virtual bimaxillary surgical plan publication-title: J Oral Maxillofac Surg – volume: 49 start-page: 62 year: 2020 end-page: 68 ident: bib5 article-title: Precision of orthognathic digital plan transfer using patient-specific cutting guides and osteosynthesis versus mixed analogue–digitally planned surgery: a randomized controlled clinical trial publication-title: Int J Oral Maxillofac Surg – volume: 7 start-page: 9314 year: 2017 ident: bib8 article-title: Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery publication-title: Sci Rep – volume: 75 start-page: 2430 year: 2017 end-page: 2440 ident: bib11 article-title: A systematic review to uncover a universal protocol for accuracy assessment of 3-dimensional virtually planned orthognathic surgery publication-title: J Oral Maxillofac Surg – volume: 18 start-page: 826 year: 2007 end-page: 832 ident: bib14 article-title: Mathematical modeling and numerical simulation in maxillofacial virtual surgery publication-title: J Craniofac Surg – volume: 49 start-page: 454 year: 2020 end-page: 460 ident: bib3 article-title: Splintless surgery using patient-specific osteosynthesis in Le Fort I osteotomies: a randomized controlled multi-centre trial publication-title: Int J Oral Maxillofac Surg – volume: 45 start-page: 1578 year: 2017 end-page: 1585 ident: bib1 article-title: Clinical accuracy of waferless maxillary positioning using customized surgical guides and patient specific osteosynthesis in bimaxillary orthognathic surgery publication-title: J Craniomaxillofac Surg – volume: 11 year: 2016 ident: bib12 article-title: A new 3D tool for assessing the accuracy of bimaxillary surgery: the OrthoGnathicAnalyser publication-title: PLoS One – volume: 3 start-page: 21 year: 2007 ident: bib16 article-title: The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension publication-title: Head Face Med – volume: 43 start-page: 957 year: 2014 end-page: 965 ident: bib15 article-title: Virtual planning in orthognathic surgery publication-title: Int J Oral Maxillofac Surg – volume: 45 start-page: 472 year: 2016 end-page: 475 ident: bib7 article-title: Mandible-first sequence in bimaxillary orthognathic surgery: a systematic review publication-title: Int J Oral Maxillofac Surg – volume: 148 start-page: 1101 year: 2021 end-page: 1110 ident: bib4 article-title: Randomized clinical trial of the accuracy of patient-specific implants versus CAD/CAM splints in orthognathic surgery publication-title: Plast Reconstr Surg – volume: 42 start-page: 377 year: 2009 end-page: 381 ident: bib10 article-title: Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support publication-title: J Biomed Inform – volume: 16 year: 2021 ident: bib13 article-title: Validation of the OrthoGnathicAnalyser 2.0—3D accuracy assessment tool for bimaxillary surgery and genioplasty publication-title: PLoS One – volume: 50 start-page: 494 year: 2021 end-page: 500 ident: bib18 article-title: Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates publication-title: Int J Oral Maxillofac Surg – volume: 7 start-page: 9314 year: 2017 ident: 10.1016/j.ijom.2025.01.016_bib8 article-title: Achievability of 3D planned bimaxillary osteotomies: maxilla-first versus mandible-first surgery publication-title: Sci Rep doi: 10.1038/s41598-017-09488-4 – volume: 3 start-page: 21 year: 2007 ident: 10.1016/j.ijom.2025.01.016_bib16 article-title: The hierarchy of stability and predictability in orthognathic surgery with rigid fixation: an update and extension publication-title: Head Face Med doi: 10.1186/1746-160X-3-21 – volume: 50 start-page: 494 year: 2021 ident: 10.1016/j.ijom.2025.01.016_bib18 article-title: Accuracy of maxillary repositioning surgery using CAD/CAM customized surgical guides and fixation plates publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2020.08.009 – volume: 77 start-page: 1882 year: 2019 ident: 10.1016/j.ijom.2025.01.016_bib9 article-title: Does mandible-first sequencing increase maxillary surgical accuracy in bimaxillary procedures? publication-title: J Oral Maxillofac Surg doi: 10.1016/j.joms.2019.03.023 – volume: 45 start-page: 472 year: 2016 ident: 10.1016/j.ijom.2025.01.016_bib7 article-title: Mandible-first sequence in bimaxillary orthognathic surgery: a systematic review publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2015.10.008 – volume: 46 start-page: 1298 year: 2017 ident: 10.1016/j.ijom.2025.01.016_bib2 article-title: A new approach of splint-less orthognathic surgery using a personalized orthognathic surgical guide system: a preliminary study publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2017.03.025 – volume: 49 start-page: 454 year: 2020 ident: 10.1016/j.ijom.2025.01.016_bib3 article-title: Splintless surgery using patient-specific osteosynthesis in Le Fort I osteotomies: a randomized controlled multi-centre trial publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2019.08.005 – volume: 16 year: 2021 ident: 10.1016/j.ijom.2025.01.016_bib13 article-title: Validation of the OrthoGnathicAnalyser 2.0—3D accuracy assessment tool for bimaxillary surgery and genioplasty publication-title: PLoS One doi: 10.1371/journal.pone.0246196 – volume: 148 start-page: 1101 year: 2021 ident: 10.1016/j.ijom.2025.01.016_bib4 article-title: Randomized clinical trial of the accuracy of patient-specific implants versus CAD/CAM splints in orthognathic surgery publication-title: Plast Reconstr Surg doi: 10.1097/PRS.0000000000008427 – volume: 42 start-page: 377 year: 2009 ident: 10.1016/j.ijom.2025.01.016_bib10 article-title: Research electronic data capture (REDCap)—a metadata-driven methodology and workflow process for providing translational research informatics support publication-title: J Biomed Inform doi: 10.1016/j.jbi.2008.08.010 – volume: 45 start-page: 1578 year: 2017 ident: 10.1016/j.ijom.2025.01.016_bib1 article-title: Clinical accuracy of waferless maxillary positioning using customized surgical guides and patient specific osteosynthesis in bimaxillary orthognathic surgery publication-title: J Craniomaxillofac Surg doi: 10.1016/j.jcms.2017.06.027 – volume: 13 start-page: 125 year: 2023 ident: 10.1016/j.ijom.2025.01.016_bib6 article-title: Three-dimensional accuracy and stability of personalized implants in orthognathic surgery: a systematic review and a meta-analysis publication-title: J Pers Med doi: 10.3390/jpm13010125 – volume: 26 start-page: 137 year: 2022 ident: 10.1016/j.ijom.2025.01.016_bib19 article-title: Efficacy and cost of maxillary patient-specific implants in orthognathic surgery: a review of three patient cases publication-title: Perm J doi: 10.7812/TPP/21.054 – volume: 49 start-page: 62 year: 2020 ident: 10.1016/j.ijom.2025.01.016_bib5 article-title: Precision of orthognathic digital plan transfer using patient-specific cutting guides and osteosynthesis versus mixed analogue–digitally planned surgery: a randomized controlled clinical trial publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2019.06.023 – volume: 75 start-page: 2430 year: 2017 ident: 10.1016/j.ijom.2025.01.016_bib11 article-title: A systematic review to uncover a universal protocol for accuracy assessment of 3-dimensional virtually planned orthognathic surgery publication-title: J Oral Maxillofac Surg doi: 10.1016/j.joms.2017.05.025 – volume: 80 start-page: 827 year: 2022 ident: 10.1016/j.ijom.2025.01.016_bib17 article-title: Comparison of the accuracy of maxillary positioning with interim splints versus patient-specific guides and plates in executing a virtual bimaxillary surgical plan publication-title: J Oral Maxillofac Surg doi: 10.1016/j.joms.2022.01.006 – volume: 11 year: 2016 ident: 10.1016/j.ijom.2025.01.016_bib12 article-title: A new 3D tool for assessing the accuracy of bimaxillary surgery: the OrthoGnathicAnalyser publication-title: PLoS One doi: 10.1371/journal.pone.0149625 – volume: 18 start-page: 826 year: 2007 ident: 10.1016/j.ijom.2025.01.016_bib14 article-title: Mathematical modeling and numerical simulation in maxillofacial virtual surgery publication-title: J Craniofac Surg doi: 10.1097/scs.0b013e318068434b – volume: 43 start-page: 957 year: 2014 ident: 10.1016/j.ijom.2025.01.016_bib15 article-title: Virtual planning in orthognathic surgery publication-title: Int J Oral Maxillofac Surg doi: 10.1016/j.ijom.2014.03.011 – volume: 60 start-page: 537 year: 2022 ident: 10.1016/j.ijom.2025.01.016_bib20 article-title: Accuracy and cost effectiveness of a waferless osteotomy approach, using patient specific guides and plates in orthognathic surgery: a systematic review publication-title: Br J Oral Maxillofac Surg doi: 10.1016/j.bjoms.2021.05.005
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Snippet	Patient-specific osteosynthesis plates and three-dimensional virtual surgical planning with patient-specific surgical guides have significantly advanced... AbstractPatient-specific osteosynthesis plates and three-dimensional virtual surgical planning with patient-specific surgical guides have significantly...
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SubjectTerms	Adolescent Adult Bone Plates Computer-aided design Cone-Beam Computed Tomography Female Humans Imaging, Three-Dimensional Male Mandible - surgery Maxilla - surgery Oral and Maxillofacial Surgery Orthognathic surgery Orthognathic Surgical Procedures - instrumentation Orthognathic Surgical Procedures - methods Patient-specific computational modelling Splints Surgery, Computer-Assisted - methods Three-dimensional imaging Treatment Outcome
Title	Maxilla-first patient-specific osteosynthesis vs mandible-first bimaxillary orthognathic surgery using splints: a randomized controlled trial
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