Application and accuracy assessment of a novel 3D-printed osteotomy guide in anterior maxillary segmental distraction osteogenesis

doi:10.3969/j.issn.1674-8115.2024.01.005

Journal of Shanghai Jiao Tong University (Medical Science) ›› 2024, Vol. 44 ›› Issue (1): 43-49.doi: 10.3969/j.issn.1674-8115.2024.01.005

• Clinical research • Previous Articles Next Articles

Application and accuracy assessment of a novel 3D-printed osteotomy guide in anterior maxillary segmental distraction osteogenesis

WAN Teng(), JIANG Tengfei, ZHU Min, WANG Xudong()

Department of Oral & Cranio-Maxillofacial Surgery, Shanghai Ninth People′s Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai 200011, China

Received:2023-05-30 Accepted:2023-10-25 Online:2024-01-28 Published:2024-02-28
Contact: WANG Xudong E-mail:wonton1984@gmail.com;xudongwang70@hotmail.com
Supported by:
National Key R&D Program of China(2023YFC2414100);National Natural Science Foundation of China(82370905);Shanghai Professional Service Platform of Oral-Cranio-Maxillofacial Digital Technology Research and Application(21DZ2294600);National Clinical Key Specialty(Z155080000004);Shanghai′s Top Priority Research Center(2022ZZ01017);CAMS Innovation Fund for Medical Sciences(2019-I2M-5-037);"Two-hundred Talents" Program of Shanghai Jiao Tong University School of Medicine(20152225)

Abstract

Abstract:

Objective ·To evaluate the effects of anterior maxillary segmental distraction osteogenesis (AMSDO) in treating sagittal maxillary hypoplasia in cleft lip and palate (CLP) patients and to report a 3D-printed surgical guide to facilitate the osteotomy. Methods ·Twelve patients with CLP who underwent AMSDO were included in this study. Virtual osteotomy was performed in a 3-dimensional model and the osteotomy line were fabricated into a tooth-borne surgical guide by using 3D-printing technique. Lateral cephalograms taken before surgery (T0), at the end of consolidation (T1) and six months after consolidation (T2) were used to evaluate the effects of AMSDO. The accuracy of the osteotomy guide was measured by superimposing the postoperative CT data to virtual planning. Results ·All the patients went through surgery without serious complications. SNA and overjet changed significantly both from T0 to T1 and from T0 to T2. ANB, facial convexity, and palatal length changed without significance from T0 to T1 and from T0 to T2. SNB remained stable. All the variables remained relatively stable from T1 to T2. The anteroposterior linear root-mean-square deviation (RMSD) between planning and actual results was 0.90 mm, while the angular RMSD in the sagittal plane was 5.07°. Conclusion ·AMSDO is an effective treatment for maxillary hypoplasia secondary to CLP. The accuracy of this 3D-printed osteotomy guide is clinically acceptable, and this can simplify the surgery with fewer complications.

Key words: anterior maxillary segmental distraction osteogenesis (AMSDO), cleft lip and palate (CLP), 3D printing, osteotomy guide, maxillary hypoplasia

CLC Number:

R782.2

WAN Teng, JIANG Tengfei, ZHU Min, WANG Xudong. Application and accuracy assessment of a novel 3D-printed osteotomy guide in anterior maxillary segmental distraction osteogenesis[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(1): 43-49.

Figures/Tables 7

Fig 1 Design of the osteotomy line

Fig 2 Separation of the anterior and posterior segments of the maxilla

Fig 3 Design of the osteotomy guide

Fig 4 Application of osteotomy guide during surgery

Fig 5 Two types of tooth-borne distractors

Fig 6 Superimposition of the actual result with virtual planning

Tab 2 Positional and angular differences between the planned and post-operative outcomes （n=9）

Parameter	RMSD	x±s
Horizontal/mm	0.65	0.54±0.37
Sagittal/mm	0.90	0.71±0.57
Vertical/mm	1.18	1.01±0.62
X-Y plane/(°)	14.87	-5.03±14.4
X-Z plane/(°)	4.19	0.17±4.31
Y-Z plane /(°)	5.07	0.99±5.11

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References 16

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Application and accuracy assessment of a novel 3D-printed osteotomy guide in anterior maxillary segmental distraction osteogenesis

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