Open Herald: Periodical of Methodical Research

Комплексная концепция виртуального ортогнатического планирования у пациентов, впервые проходящих хирургическое вмешательство

Матчанов Бобур Бахтиёр углы

Ассистент кафедры челюстно-лицевой хирургии и стоматологии Ташкентской медицинской академии

Keywords: CAD/CAM, Компьютерное хирургическое моделирование, Ортогнатическая хирургия

---

Abstract

To date, the problem of traumatic injuries of the middle The "surgery first" concept is becoming increasingly popular in orthognathic surgery as it offers major benefits such as reduced treatment duration and increased patient satisfaction by eliminating preoperative orthodontic decompensation phases. Here, we present a new interdisciplinary pathway for fully virtual orthodontic surgical planning in the surgical setting using a 3D-printed cutting template and a customized maxillary implant for Le Fort I osteotomy, as well as a CAD/CAM-based definitive stereolithography splint. Patient data obtained from cranial cone beam computed tomography and full dental scans were processed using OnyxCeph3TM software (Image Instruments). The orthodontist and oral surgeon performed a joint computerized surgical simulation to determine three-dimensional movements of the maxilla and mandible. In a separate virtual planning session, the surgeon developed a customized maxillary template and implant for precise intraoperative transfer (Geomagic Freeform Plus software, 3DSystems). The final 3D printed CAD/CAM splint was fabricated by the orthodontist and used to accurately reduce the mandible

---

References

Дубровин В. Н., Баширов В. И., Фурман Я. А. и др. Оптимизация хирургического доступа

при проведении ретроперитонеоскопической уретеролитотомии с применением

компьютерной 3D реконструкции. Экспериментальная и клиническая урология. 2013, № 4: 86–

Щаденко С. В., Горбачёва А. С., Арсланова А. Р. и др. 3d визуализация для планирования

операций и выполнения хирургического вмешательства (cas-технологии). Бюллетень

сибирской медицины. 2014, № 4:165–171.

Большаков О. П. Развитие методов и направлений анатомических исследований. СПб.:

Наука, 2015.

Hernández-Alfaro F, Guijarro-Martinez R, Peiro-Guijarro MA. Surgery first in orthognathic

surgery: what have we learned? A comprehensive workflow based on 45 consecutive cases. J Oral

Maxillofac Surg 2014;72:376–390. 5.. Uribe F, Agarwal S, Shafer D, et al. Increasing orthodontic

and orthognathic surgery treatment efficiency with a modified surgery-first approach. Am J Orthod

Dentofacial Orthop 2015;148:838–848. 6.. Huang CS, Chen YR. Orthodontic principles and

guidelines for the surgery-first approach to orthognathic surgery. Int J Oral Maxillofac Surg

;44:1457–14627. Kim JW, Kim JC, Jeong CG, et al.The accuracy and stability of the maxillary position after

orthognathic surgery using a novel computeraided surgical simulation system. BMC Oral Health

;19:18.

Dos Santos PR, Meneghim MC, Ambrosano GM, et al. Influence of quality of life, self perception,

and self-esteem on orthodontic treatment need. Am J Orthod Dentofacial Orthop 2017;151:143–147.

Grewal H, Sapawat P, Modi P, et al. Psychological impact of orthodontic treatment on quality of

life – a longitudinal study. Int Orthod 2019;17:269–276.

Klein KP, Kaban LB, Masoud MI. Orthognathic surgery and orthodontics: Inadequate planning

leading to complications or unfavorable results. Oral Maxillofac Surg Clin North Am 2020;32:71–

Alkhayer A, Piffkó J, Lippold C, et al. Accuracy of virtual planning in orthognathic surgery: a

systematic review. Head Face Med 2020;16:34.

Schneider D, Kämmerer PW, Hennig M, et al. Customized virtual surgical planning in bimaxillary

orthognathic surgery: a prospective randomized trial. Clin Oral Investig 2019;23:3115–3122.

Choi DS, Garagiola U, Kim SG. Current status of the surgery-first approach (part I): Concepts

and orthodontic protocols. Maxillofac Plast Reconstr Surg 2019;41:10.

Naran S, Steinbacher DM, Taylor JA. Current concepts in orthognathic surgery. Plast Reconstr

Surg 2018;141:925–936.

Liou EJ, Chen PH, Wang YC, et al. Surgery-first accelerated orthognathic surgery: postoperative

rapid orthodontic tooth movement. J Oral Maxillofac Surg 2011;69:781–785.

Yang L, Xiao YD, Liang YJ, et al. Does the surgery-first approach produce better outcomes in

orthognathic surgery? A systematic review and meta-analysis. J Oral Maxillofac Surg 2017;75:2422–

Hernández-Alfaro F, Guijarro-Martínez R. On a definition of the appropriate timing for surgical

intervention in orthognathic surgery. Int J Oral Maxillofac Surg 2014;43:846–855.

da Costa SO, Smeets M, Willaert R, et al. Complications following one-stage versus two stage

surgical treatment of transverse maxillary hypoplasia. J Oral Maxillofac Surg 2021;79:1531–1539