The Use of Bone-borne Guides in Orthognathic Surgery Cases

Study Overview
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Brief Summary
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The present study was conducted to evaluate a new design of the intermediate stent that is used in orthognathic surgery cases requiring Le Fort I osteotomy. The new design relied on referencing the maxillary segment to the zygomatic buttress. The study was carried out as a randomized controlled clinical trial in which 16 patients were enrolled according to the inclusion and exclusion criteria. In control group (n=8) conventional interocclusal splint was used and in study group (n=8) the proposed intermediate stent was used.

Detailed Description
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Background: Dentofacial deformities have many negative consequences in the form and function of head and neck region. This includes breathing, swallowing, speech and temporomandibular disorders. It is estimated that in about 19% of orthodontic patients, orthognathic surgery is required along with the orthodontic procedure. The introduction of CAD/CAM technology in orthognathic surgery planning has facilitated the procedure and allowed for more predicted results. Aim of this study: The aim of the present study is to propose a new design of the intermediate stent that relates the mobilized maxilla to a fixed anatomical landmark in the skull which would allow for more accurate positioning of the maxilla during orthognathic surgery. Materials and methods: This study was conducted on sixteen patients who have been undergone Le Fort I osteotomy procedure. Eight of them (group A) were treated via a conventional stent while the other eight patients (group B) via a CAD/CAM bone-borne stent. Postoperative patient evaluation was performed by comparing the predicted maxillary position to the resultant position postoperatively. This was done via 3D reconstruction CT scans.

Official Title
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Evaluation of the Use of Bone-borne CAD/CAM Surgical Guides in Orthognathic Surgery Cases Requiring Le Fort I Osteotomy

Conditions
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Dentofacial Deformities

Intervention / Treatment
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* Device: Bone-borne CAD/CAM splint
* Device: 3D interocclusal conventional splint


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients with dentofacial deformity requiring Le Fort I osteotomy Exclusion Criteria: Patients with severe asymmetry
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Control<br>Interocclusal conventional splint is used to reposition the maxilla. | Device: 3D interocclusal conventional splint<br>* Interocclusal splint that relies on the centric relation of the condyle as well as occlusion.<br>|
| Experimental: Study<br>Bone-borne splint is used to reposition the maxilla. | Device: Bone-borne CAD/CAM splint<br>* 3D printed splint that repositions the maxilla with the zygomatic buttress as a reference.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Error of superimposition | Superimposition error between planned and actual maxillary position | 2 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Visual Analogue Scale | Pain assessed by score from 0 to 10 with 0 no pain and 10 severe unbearable pain. | 3 months | 
| Procedure duration | Time of the surgery using the splint | 1 day | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Le Fort, Orthognathic surgery, Virtual surgical planning