Skip to main content

Advertisement

SpringerLink
Log in

The Application of 3D Printing Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities

  • Original Article
  • Craniofacial/Maxillofacial
  • Published:
Aesthetic Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Because of the limitation of specific preoperative design and surgical templates, orthognathic surgery and mandibular contour osteoplasty are generally performed in two stages. Three-dimensional printing technology has improved the accuracy of the surgery and results in good surgical predictability easily. This study aims to confirm the effectiveness, feasibility and precision of simultaneous mandibular contour osteoplasty and orthognathic surgery with the assistance of 3D printing technology.

Methods

Ten patients, who were diagnosed with mandibular hypertrophy and bimaxillary deformities, were included in the study. In addition to conventional orthognathic surgery, mandibular angle ostectomy, mandibular outer cortex grinding or mandibular border ostectomy was designed for mandibular hypertrophy. Optimal osteotomy lines and simulated surgeries were designed according the 3D printing model of the mandible. Then, surgical templates were made on the 3D printing model. No muscle excision was performed in any patient. Preoperative, predicted and postoperative measurements were taken, including the gonial angle (Ar–Go–Me) and the mandibular width (Go–Go).

Results

All the patients had a reposeful postoperative recovery, with no indication of obvious infection, facial paralysis, osteonecrosis or bone displacement. The gonial angle was improved from 110.3° ± 11.1 to 121.3° ± 2.9, and the mandibular width was improved from 117.5 mm ± 6.8 to 111.9 mm ± 4.2. The discrepancies between simulation and postoperation of the left gonial angle, the right gonial angle and the mandibular width were 0.56° ± 0.22, 0.65° ± 0.3 and 0.49 mm ± 0.43, respectively.

Conclusions

The results of our study illustrated the predictability, feasibility and reliability of simultaneous mandibular contour osteoplasty and orthognathic surgery with the assistance of 3D printing technology. Our technique could achieve functional improvement and an aesthetic profile at the same time.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8
Fig. 9
Fig. 10
Fig. 11
Fig. 12
Fig. 13
Fig. 14
Fig. 15
Fig. 16
Fig. 17

Similar content being viewed by others

References

  1. Terajima M, Nakasima A, Aoki Y, Goto TK, Tokumori K, Mori N, Hoshino Y (2009) A 3-dimensional method for analyzing the morphology of patients with maxillofacial deformities. Am J Orthod Dentofacial Orthop 136(6):857–867

    Article  PubMed  Google Scholar 

  2. Lonic D, Lo LJ (2016) Three-dimensional simulation of orthognathic surgery-surgeon’s perspective. J Formos Med Assoc 115(6):387–388

    Article  PubMed  Google Scholar 

  3. Borzabadi-Farahani A, Eslamipour F, Shahmoradi M (2016) Functional needs of subjects with dentofacial deformities: a study using the index of orthognathic functional treatment need (IOFTN). J Plast Reconstr Aesthet Surg 69(6):796–801

    Article  PubMed  Google Scholar 

  4. Tian KY, Li QQ, Liu XJ, Wang XX, Li ZL, Wang X (2016) Evaluation of therapeutic effect of virtual design for correcting facial asymmetry of skeletal Class III deformity. Zhonghua Kou Qiang Yi Xue Za Zhi 51(10):594–599

    CAS  PubMed  Google Scholar 

  5. Cousley RR, Turner MJ (2014) Digital model planning and computerized fabrication of orthognathic surgery wafers. J Orthod 41(1):38–45

    Article  PubMed  Google Scholar 

  6. Suojanen J, Leikola J, Stoor P (2017) The use of patient-specific implants in orthognathic surgery: a series of 30 mandible sagittal split osteotomy patients. J Craniomaxillofac Surg 44(12):1913–1916

    Article  Google Scholar 

  7. Wang L, Tian D, Sun X, Xiao Y, Chen L, Wu G (2017) The precise repositioning instrument for genioplasty and a three-dimensional printing technique for treatment of complex facial asymmetry. Aesth Plast Surg. doi:10.1007/s00266-017-0875-2

    Google Scholar 

  8. Hernandez-Alfaro F, Guijarro-Martinez R (2013) New protocol for three-dimensional surgical planning and CAD/CAM splint generation in orthognathic surgery: an in vitro and in vivo study. J Oral Maxillofac Surg 42:1547–1556

    Article  CAS  Google Scholar 

  9. Lee YC, Sohn HB, Kim SK, Bae OY, Lee JH (2015) A novel method for the management of proximal segment using computer assisted simulation surgery: correct condyle head positioning and better proximal segment placement. Maxillofac Plast Reconstr Surg 37(1):21

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gateno J, Xia JJ, Teichgraeber JF (2011) New 3-dimensional cephalometric analysis for orthognathic surgery. J Oral Maxillofac Surg 69(3):606–622

    Article  PubMed  PubMed Central  Google Scholar 

  11. Popat H, Richmond S, Marshall D, Rosin P (2012) Three-dimensional assessment of functional change following class 3 orthognathic correction—a preliminary report. J Cranio maxillofac Surg 40:36–42

    Article  Google Scholar 

  12. Ireland AJ, Cunningham SJ, Petrie A (2014) An index of orthognathic functional treatment need (IOFTN). J Orthod 41:77–83

    Article  PubMed  PubMed Central  Google Scholar 

  13. Ye N, Long H, Zhu S (2015) The accuracy of computer image-guided template for mandibular angle ostectomy. Aesthet Plast Surg 39:117

    Article  Google Scholar 

  14. Zhao M, ZWu G (2017) The appropriative retractors for genioplasty. J Craniofac Surg 28(1):252–253

    Article  PubMed  Google Scholar 

  15. Kim CH, Lee JH, Cho JY, Kim KW (2007) Skeletal stability after simultaneous mandibular angle resection and sagittal split ramus osteotomy for correction of mandible prognathism. J Oral Maxillofac Surg 65:192

    Article  PubMed  Google Scholar 

  16. Hsu SSP, Gateno J, Bell RB, Hirsch DL, Markiewicz MR, Teichgraeber JF, Zhou XB, Xia JJ (2013) Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study. J Oral Maxillofac Surg 71(1):128–142

    Article  PubMed  Google Scholar 

  17. Tucker S, Cevidanes LHS, Styner M, Kim H, Reyes M, Proffit W, Turvey T (2010) Comparison of actual surgical outcomes and 3-dimensional surgical simulations. J Oral Maxillofac Surg 61(10):2412–2421

    Article  Google Scholar 

  18. Marmulla R, Wo¨rtche R, Mu¨hling J, Hassfeld S (2005) Geometric accuracy of the NewTom 9000 cone beam CT. Dentomaxillofac Radiol 34:28–31

    Article  CAS  PubMed  Google Scholar 

  19. Maloney K, Bastidas J, Freeman K, Olson TR, Kraut RA (2011) Cone beam computed tomography and SimPlant materialize dental software versus direct measurement of the width and height of the posterior mandible: an anatomic study. J Oral Maxillofac Surg 69:1923–1929

    Article  PubMed  Google Scholar 

  20. Sun XM, Wu GM (2015) The precise repositioning instrument for genioplasty. J Craniofac Surg 26(8):2417

    Article  PubMed  Google Scholar 

  21. Mao XB, Wang T, Yang DK, Zang GM (2011) The dynamics of blood supply of animal experimental study for simultaneous mandibular sagittal split osteotomy and mandibular angle plasty. J Chongqing Med Univ 6(36):718–720

    Google Scholar 

  22. Anderson J Greg, Laney Thomas J (2002) Combined orthognathic and facial aesthetic surgery with case reports. J Tenn Dent Assoc 82(3):52

    PubMed  Google Scholar 

  23. RaffainiM Pisani C (2015) Orthognathic surgery with or without autologous fat micrograft injection: preliminary report on aesthetic outcomes and patient satisfaction. Int J Oral Maxillofac Surg 44(3):362–370

    Article  Google Scholar 

  24. Trawitzki LV, Dantas RO, Mello-Filho FV, Elias-Júnior J (2006) Effect of treatment of dentofacial deformity on masseter muscle thickness. Arch Oral Biol 51(12):1086–1092

    Article  PubMed  Google Scholar 

  25. Lee ST, Mori Y, Minami K, An CH, Park JW, Kwon TG (2013) Does skeletal surgery for asymmetric mandibular prognathism influence the soft tissue contour and thickness? J Oral Maxillofac Surg 71(9):1577–1587

    Article  PubMed  Google Scholar 

  26. Sarver DM, Rousso DR (2004) Plastic surgery combined with orthodontic and orthognathic procedures. Am J Orthod Dentofacial Orthop 126(3):305–307

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

This study was funded by grants from the Committee of National Nature Science Foundation (No. 81400532) in China, Norman Bethune Program of Jilin University (No. 2015301), Fund Project of Jilin Health and Family Planning Commission (No. 2015Q017), Jilin University’s Outstanding Young Teacher Training Program (No. 419080500367), the Program for Fundamental Research of Jilin University (No. 450060491134) and the 13th Five-Year science and technology project of the Education Department of Jilin Province (No. 2016486).

Author information

Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Jilin University, No. 1500 Qinghua Road, Changchun, 130021, Jilin, China

    Yanju Xiao, Lin Wang, Yaoyao Zhang, Kai Chen & Guomin Wu

  2. Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, China

    Xiumei Sun

Authors
  1. Yanju Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xiumei Sun
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lin Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yaoyao Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kai Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Guomin Wu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Guomin Wu.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the hospital research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xiao, Y., Sun, X., Wang, L. et al. The Application of 3D Printing Technology for Simultaneous Orthognathic Surgery and Mandibular Contour Osteoplasty in the Treatment of Craniofacial Deformities. Aesth Plast Surg 41, 1413–1424 (2017). https://doi.org/10.1007/s00266-017-0914-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00266-017-0914-z

Keywords

Search

Navigation