Three-Dimensional Evaluation of Skeletal Stability following Surgery-First Orthognathic Approach: Validation of a Simple and Effective Method.

Autor: Mansour NM; Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt., Abdelshaheed ME; Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt., El-Sabbagh AH; Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt., El-Din AMB; Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt., Kim YC; Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center, Seoul, South Korea., Choi JW; Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center, Seoul, South Korea.
Jazyk: angličtina
Zdroj: Archives of plastic surgery [Arch Plast Surg] 2023 May 29; Vol. 50 (3), pp. 254-263. Date of Electronic Publication: 2023 May 29 (Print Publication: 2023).
DOI: 10.1055/a-2058-8108
Abstrakt: Background  The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods  This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results  Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion  This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.
Competing Interests: Conflict of Interest None declared.
(The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. ( https://creativecommons.org/licenses/by/4.0/ ).)
Databáze: MEDLINE
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