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Evaluation of computer-guided condylarpositioning device in bilateral sagittalsplit ostetomies

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Oral & Maxillofacial Surgery

Authors

Abou-El-Futouh, Adel Hamdi

Accessioned

2018-08-26 05:48:02

Available

2018-08-26 05:48:02

type

M.D. Thesis

Abstract

Objectives: This study was designed to evaluate the accuracy of a computer generated condylar positioning device in maintaining the spatial orientation of the condyle after performing bilateral sagittal split osteotomy.Patients and methods: Six patients requiring bilateral sagittal split osteotomies (BSSO) for correction of their skeletal deformity were enrolled in this study. A preoperative cone beam CT scan was obtained for each patient and imported into surgical planning software where a virtual BSSO was simulated. The CTs of the patients were augmented with the detailed CT scans of their dental casts in final occlusion. The virtual distal segment was repositioned to match the final occlusion and a stent designed to maintain the planned condylar position. Immediate postoperative CTs were used to compare the planned condylar position to the actual outcome. Results: The condylar positioning device design; as presented in this study; offered excellent clinical outcomes in terms of occlusion and postoperative TMD while it offered less than optimal condylar repositioning as evaluated radiographically. Also it showed better linear condylar repositioning in the vertical and anteroposterior directions than in the mediolateral direction. Angular condylar position changes were more difficult to control. The presented CPD showed good control over the location of bicortical fixation screws and maintained gaps between proximal and distal segments, both merits resulted in a low incidence of inferior alveolar nerve neurosensory affection.Conclusion: Computer-assisted surgical simulation of bilateral sagittal split osteotomies allowed for excellent reproduction of the virtual anatomy, osteotomy line positions, predicted ramus-splitting patterns and predicted resultant gaps or interferences in almost every case. Despite the added planning and intraoperative times, virtual simulation and computer-generated templates allowed for better reproducibility of the surgical plan.

Issued

1 Jan 2012

DOI

http://dx.doi.org/10.21473/iknito-space/39964

Details

Type

Thesis

Created At

28 Jan 2023