3D Digital Orthognathic Surgery Planning: A Case Study of Mandibular Retrusion and Asymmetry

This case study presents the planning process and surgical outcomes of a patient with micrognathia and asymmetry using 3D digital orthognathic surgery. The surgical plan was developed using the Facegide Lite CAD program, a tool designed for precise digital orthognathic surgery.

What is 3D Digital Orthognathic Surgery?

3D digital orthognathic surgery utilizes three-dimensional CT data to perform virtual surgery, followed by the creation of customized surgical tools to enhance accuracy and predictability.

This approach allows for precise bone movement and resection planning, minimizing errors through the use of custom metal plates and surgical guides tailored to the patient.

3D 디지털 양악수술

Understanding Faceguide in 3D Digital Orthognathic Surgery

Facegide is a comprehensive solution for 3D digital orthognathic surgery, consisting of the following components:

• Software: Facegide Lite

• Hardware: Surgical guides (saw guide) and patient-specific metal plates (faceplate)

The surgical planning process using Facegide includes:

1. CT Data Analysis: Reconstruction of a 3D image to identify skeletal issues.

2. Integration with R2GATE Program: Alignment of CT and dental scan data, segmentation of bone structures.

3. Virtual Surgery with Facegide Lite: Simulation of surgery to determine bone movement and resection amounts.

4. Production of Custom Metal Plates and Surgical Guides: Fabrication of tools to precisely execute the surgical plan.

   
   

Case Analysis

 Patient Information

Micrognathia with facial asymmetry

• Diagnosis: Micrognathia with facial asymmetry

• Deviation: 3.34mm deviation of chin to the right

• ANB Angle: 8.4 degrees

Surgical Plan

• Maxillary Le Fort I Osteotomy: Counterclockwise rotation

• Mandibular SSRO Osteotomy: Mandibular advancement

• Genioplasty Advancement

• Mandibular Angle Resection: Performed only on the left side for asymmetry correction)

Surgical Process

1. Surgical Occlusion Setup: Verification of skeletal movement

   

   Surgical Occlusion Setup

2. Orthognathic Surgery Simulation: Adjustment of bone movement with Facegide Lite

   

   Orthognathic Surgery Simulation

3. Counterclockwise Rotation Surgery: Correction of occlusal plane inclination

   

   Counterclockwise Rotation Surgery

4. Additional Asymmetry Correction: Fine-tuning of bone movement

   

   Additional Asymmetry Correction

5. Ramus Angle Adjustment: Achieving a natural mandibular contour

   

   3D Digital Orthognathic Surgery Planning

6. Overcorrection: Addressing potential postoperative relapse with additional adjustments to the chin and mandibular body

   
   

Surgical Outcomes

3D Digital Orthognathic Surgery Planning

3D Digital Orthognathic Surgery Planning

• Successful correction of micrognathia and asymmetry using 3D digital orthognathic surgery

• High consistency between surgical plan and actual outcome

• Slight relapse of the mandible to the right observed at 5 months post-surgery

• Minimal surgical error confirmed through 3D analysis

  

  surgical error through 3D analysis

  

  surgical error through 3D Digital Orthognathic Surgery

Conclusion

3D digital orthognathic surgery, utilizing the Facegide system, provides an effective solution for correcting skeletal issues in patients with micrognathia and asymmetry. The application of counterclockwise rotational surgery allows for precise adjustment of the occlusal plane inclination and improved surgical accuracy.

This case demonstrates the precision and predictability of 3D digital orthognathic surgery, offering valuable insights for patients seeking correction of micrognathia and facial asymmetry.

https://blog.naver.com/vvsaz144/223465005535

3D Digital Orthognathic Surgery Planning