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Application and accuracy assessment of a novel 3D-printed osteotomy guide in anterior maxillary segmental distraction osteogenesis
Received date: 2023-05-30
Accepted date: 2023-10-25
Online published: 2024-01-28
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)
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.
Teng WAN , Tengfei JIANG , Min ZHU , Xudong WANG . 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 . DOI: 10.3969/j.issn.1674-8115.2024.01.005
1 | WANG M, YUAN Y, WANG Z, et al. Prevalence of orofacial clefts among live births in China: a systematic review and meta-analysis: prevalence of oral clefts in China[J]. Birth Defects Res, 2017, 109(13): 1011-1019. |
2 | CAPELOZZA FILHO L, NORMANDO A D, DA SILVA FILHO O G. Isolated influences of lip and palate surgery on facial growth: comparison of operated and unoperated male adults with UCLP[J]. Cleft Palate Cran J, 1996, 33(1): 51-56. |
3 | CHEUNG L K, CHUA H D P, H?gg M B. Cleft maxillary distraction versus orthognathic surgery: clinical morbidities and surgical relapse[J]. Plast Reconstr Surg, 2006, 118(4): 996-1008. |
4 | 张继生, 唐友盛, 卢晓峰, 等. 上颌骨牵引成骨对腭咽闭合功能的影响[J]. 临床口腔医学杂志, 2004, 20(3): 168-170. |
4 | ZHANG J S, TANG Y S, LU X F.Effects of maxillary DO on velopharyngeal function[J]. Journal of Clinical Stomatology, 2004, 20(3): 168-170. |
5 | YU H, WANG X, FANG B, et al. Comparative study of different osteotomy modalities in maxillary distraction osteogenesis for cleft lip and palate[J]. J Oral Maxillofac Surg, 2012, 70(11): 2641-2647. |
6 | RICHARDSON S, SELVARAJ D, KHANDEPARKER R V, et al. Tooth-borne anterior maxillary distraction for cleft maxillary hypoplasia: our experience with 147 patients[J]. J Oral Maxillofac Surg, 2016, 74(12): 2504.e1-2504.e14. |
7 | LIU X, CHEN Z. Effects of palate repair on cranial base and maxillary morphology in patients with unilateral complete cleft lip and palate[J]. Cleft Palate Craniofac J, 2018, 55(10): 1367-1374. |
8 | SALGADO K R, WENDT A R, FERNANDES FAGUNDES N C, et al. Early or delayed palatoplasty in complete unilateral cleft lip and palate patients? A systematic review of the effects on maxillary growth[J]. J Craniomaxillofac Surg, 2019, 47(11): 1690-1698. |
9 | KAPPEN I F P M, YODER W R, MINK VAN DER MOLEN A B, et al. Long-term craniofacial morphology in young adults treated for a non-syndromal UCLP: a systematic review[J]. J Plast Reconstr Aesthet Surg, 2018, 71(4): 504-517. |
10 | MCCARTHY J G, SCHREIBER J, KARP N, et al. Lengthening the human mandible by gradual distraction[J]. Plast Reconstr Surg, 1992, 89(1): 1-8; discussion9-10. |
11 | 刘庆成, 王敏娇, 司家文, 等. 前段截骨牵引治疗唇腭裂继发上颌骨发育不足[J]. 口腔颌面外科杂志, 2017, 27(3): 179-184. |
11 | LIU Q C, WANG M J, SI J W, et al. Clinical evaluation on the anterior maxillary segmental distraction with rigid external distraction in the treatment of severe maxillary hypoplasia secondary to CLP[J]. Journal of Oral and Maxillofacial Surgery, 2017, 27(3): 179-184. |
12 | AKSU M, TANER T, SAHIN-VESKE P, et al. Pharyngeal airway changes associated with maxillary distraction osteogenesis in adult cleft lip and palate patients[J]. J Oral Maxillofac Surg, 2012, 70(2): e133-e140. |
13 | RICHARDSON S, SEELAN N S, SELVARAJ D, et al. Perceptual speech assessment after anterior maxillary distraction in patients with cleft maxillary hypoplasia[J]. J Oral Maxillofac Surg, 2016, 74(6): 1239.e1-1239.e9. |
14 | 牟思璇, 朱妍菲, 杜常欣, 等. 改良牙支持式上颌骨前部牵引成骨术与上颌骨Le Fort Ⅰ型前徙术对唇腭裂患者腭咽部结构的影响[J]. 中国口腔颌面外科杂志, 2020, 18(5): 427-433. |
14 | MOU S X, ZHU Y F, DU C X, et al. Comparative study of modified tooth-borne anterior maxillary segmental distraction osteogenesis and Le Fort I osteotomy on velopharyngeal structure changes in cleft lip palate patients[J]. China Journal of Oral and Maxillofacial Surgery, 2020, 18(5): 427-433. |
15 | OKCU K M, SENCIMEN M, KARACAY S, et al. Anterior segmental distraction of the hypoplastic maxilla by a tooth borne device: a study on the movement of the segment[J]. Int J Oral Maxillofac Surg, 2009, 38(8): 817-822. |
16 | TANIKAWA C, HIRATA K, AIKAWA T, et al. Efficacy of maxillary anterior segmental distraction osteogenesis in patients with cleft lip and palate[J]. Cleft Palate Craniofac J, 2018, 55(10): 1375-1381. |
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