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Three-dimensional positioning of the maxilla using novel intermediate splints in maxilla-first orthognathic surgery for correction of skeletal class III deformity

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Abstract

Objectives

Successful orthognathic surgery requires accurate transfer of the intraoperative surgical plan. This study aimed to (1) evaluate the surgical error of a novel intermediate splint in positioning the maxilla during maxilla-first orthognathic surgery and (2) determine factors influencing surgical error.

Materials and methods

This prospective study examined 83 patients who consecutively underwent Le Fort I osteotomy for correction of skeletal class III deformity using a novel intermediate splint and a bilateral sagittal split osteotomy. Surgical error was the outcome variable, measured as the difference in postoperative translational and rotational maxillary position from the virtual plan. Measures included asymmetry, need and amount for mandibular opening during fabrication of intermediate splints, and planned and achieved skeletal movement.

Results

Mean errors in translation for vertical, sagittal, and transversal dimensions were 1.0 ± 0.7 mm, 1.0 ± 0.6 mm, and 0.7 ± 0.6 mm, respectively; degrees in rotation for yaw, roll, and pitch were 0.8 ± 0.6, 0.6 ± 0.4, and 1.6 ± 1.1, respectively. The transverse error was smaller than sagittal and vertical errors; error for pitch was larger than roll and yaw (both p < 0.001). Error for sagittal, transverse, and roll positioning was affected by the achieved skeletal movement (roll, p < 0.05; pitch and yaw, p < 0.001). Surgical error of pitch positioning was affected by planned and achieved skeletal movement (both p < 0.001).

Conclusions

Using the novel intermediate splint when performing Le Fort I osteotomy allowed for accurate positioning of the maxilla.

Clinical relevance

The novel intermediate splint for maxillary positioning can be reliably used in clinical routines.

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Data availability

Data are available from the corresponding author on reasonable request.

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Funding

This study was supported by the Chang Gung Memorial Hospital (CMRPG5K0181) and the National Science and Technology Council (MOST 111–2314-B-182–020-MY3).

Author information

Authors and Affiliations

  1. Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan

    Yi-Hsuan Lin, Yu-Fang Liao & Yu-Ray Chen

  2. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, Taiwan

    Yi-Hsuan Lin

  3. Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, Taiwan

    Yi-Hsuan Lin, Chuan-Fong Yao, Ying-An Chen, Yu-Fang Liao & Yu-Ray Chen

  4. Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan

    Yi-Hsuan Lin, Chuan-Fong Yao, Ying-An Chen, Yu-Fang Liao & Yu-Ray Chen

  5. Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan

    Chuan-Fong Yao, Ying-An Chen & Yu-Ray Chen

  6. Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, No. 123, Dinghu Road, Guishan District, Taoyuan City, 333, Taiwan

    Yu-Fang Liao

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Contributions

Y.H.L. and Y.F.L. wrote the main manuscript text; all authors conducted the investigations and reviewed the manuscript.

Corresponding author

Correspondence to Yu-Fang Liao.

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The study was approved by the local ethics committee of the Chang Gung Memorial Hospital. All study participants signed informed consent.

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The authors declare no competing interests.

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Lin, YH., Yao, CF., Chen, YA. et al. Three-dimensional positioning of the maxilla using novel intermediate splints in maxilla-first orthognathic surgery for correction of skeletal class III deformity. Clin Oral Invest 28, 141 (2024). https://doi.org/10.1007/s00784-024-05526-4

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