Accuracy and safety of in-house surgeon-designed three-dimensional-printed patient-specific implants for wafer-less Le Fort I osteotomy.

OBJECTIVES: The design and fabrication of three-dimensional (3D)-printed patient-specific implants (PSIs) for orthognathic surgery are customarily outsourced to commercial companies. We propose a protocol of designing PSIs and surgical guides by orthognathic surgeons-in-charge instead for wafer-less Le Fort I osteotomy. The aim of this prospective study was to evaluate the accuracy and post-operative complications of PSIs that are designed in-house for Le Fort I osteotomy. MATERIALS AND METHODS: The post-operative cone beam computer tomography (CBCT) model of the maxilla was superimposed to the virtual surgical planning to compare the discrepancies of pre-determined landmarks, lines, and principal axes between the two models. Twenty-five patients (12 males, 13 females) were included. RESULTS: The median linear deviations of the post-operative maxilla of the x, y, and z axes were 0.74 mm, 0.75 mm, and 0.72 mm, respectively. The deviations in the principal axes for pitch, yaw, and roll were 1.40°, 0.90°, and 0.60°, respectively. There were no post-operative complications related to the PSIs in the follow-up period. CONCLUSIONS: The 3D-printed PSIs designed in-house for wafer-less Le Fort I osteotomy are accurate and safe. CLINICAL RELEVANCE: Its clinical outcomes and accuracy are comparable to commercial PSIs for orthognathic surgery. TRIAL REGISTRATION: Clinical trial registration number: HKUCTR-2113. Date of registration: 29 July 2016.

Accuracy of self-designed 3D-printed patient-specific surgical guides and fixation plates for advancement genioplasty.

AIM: A prospective study was conducted to evaluate the accuracy and complications of 3D-printed patient-specific surgical guides and plates that were designed and finished in-house. MATERIALS AND METHODS: Eighteen patients who required advancement genioplasty, with or without concomitant orthognathic surgery, were enrolled in the study. Virtual surgical movements were simulated using the patient's CBCT scans, and the computer-aided designing of patient-specific surgical guides and fixation plates was performed in the authors' department. CBCT scans were taken at 1-month postoperatively, and stereolithographic models of the preoperative virtual plan and the postoperative CBCT scan were registered. Part comparisons were performed to assess the accuracy of the movements. The median, minimum, and maximum differences were measured. Two landmarks, the Menton (Me) and Pogonion (Pog), were also used to compare the differences locally. RESULTS: The median deviation for the 18 cases was 0.19 mm. The median deviation at the Me and Pog were 0.67 and 0.41 mm, respectively. There was no significant correlation between the surgical movement of < 7 mm advancement and the transfer accuracy (P = 0.77). No adverse events or complications were reported within the postoperative 6-month period. CONCLUSION: The protocol of self-designed 3D-printed patient-specific surgical guides and plates provided an accurate method to transfer the virtual surgical plan to the operating theater. (Int J Comput Dent 2022;25(4):369-0; doi: 10.3290/j.ijcd.b2599791).