The use of patient-specific implants in orthognathic surgery: A series of 30 mandible sagittal split osteotomy patients

Juho Suojanen; Junnu Leikola; Patricia Stoor

doi:10.1016/j.jcms.2017.02.021

The use of patient-specific implants in orthognathic surgery: A series of 30 mandible sagittal split osteotomy patients

J Craniomaxillofac Surg. 2017 Jun;45(6):990-994. doi: 10.1016/j.jcms.2017.02.021. Epub 2017 Mar 3.

Authors

Juho Suojanen¹, Junnu Leikola², Patricia Stoor³

Affiliations

¹ Departments of Oral and Maxillo-Facial Diseases (Head: Risto Kontio, MD, DDS, PhD), University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, 00029 HUS, Helsinki, Finland. Electronic address: [email protected].
² Cleft Lip and Palate and Craniofacial Centre (Head: Hannu Kuokkanen, MD, PhD), Helsinki University Hospital, Sibeliuksenkatu 10, 00029 HUS, Finland.
³ Departments of Oral and Maxillo-Facial Diseases (Head: Risto Kontio, MD, DDS, PhD), University of Helsinki and Helsinki University Hospital, Haartmaninkatu 4E, 00029 HUS, Helsinki, Finland.

PMID: 28381373
DOI: 10.1016/j.jcms.2017.02.021

Abstract

Purpose: Virtual surgery combined with patient-specific saw and drill guides and osteosynthesis materials are rapidly spreading from reconstructive surgery to orthognathic surgery. Most commercial partners are already providing computer-aided design and computer-aided manufacture (CAD/CAM) wafers and patient-specific saw guides. Clear benefits have been demonstrated for custom-made drill guides combined with individually designed three-dimensional (3D) printed patient-specific implants (PSI) as a reposition and fixation system in Le Fort I osteotomy.

Materials and methods: We treated 30 patients who underwent bilateral sagittal split osteotomy (BSSO) due to class II dento-skeletal deformities with the additional use of drill guides combined with PSI as a fixation and positioning system.

Results: The PSIs fitted bilaterally with total precision in 11 of the 30 patients. In 17 patients, the PSIs were used with some modifications. In 2 of 30 patients, the PSIs could not be used as a fixation due to misfit.

Conclusion: Due to unpredictable fitting, the use of PSIs with drill guides alone in BSSO without wafers cannot be recommended. Further studies are needed to evaluate the interfering parts, which seem to be related to condylar positioning and bony interferences at the osteotomy sites.

Keywords: BSSO; CAD/CAM; Orthognatic surgery; Patient specific implants; Sagittal ramus osteotomy; Sagittal split osteotomy.

MeSH terms

Adult
Female
Humans
Imaging, Three-Dimensional
Male
Malocclusion, Angle Class II / diagnostic imaging
Malocclusion, Angle Class II / surgery*
Mandible / diagnostic imaging
Mandible / surgery*
Middle Aged
Osteotomy, Sagittal Split Ramus / instrumentation*
Prostheses and Implants*
Retrospective Studies
Surgery, Computer-Assisted / methods*
Tomography, X-Ray Computed
Treatment Outcome