Our Summary

This research paper looks at the use of 3D simulation in orthognathic surgery. The authors have developed a method to measure how closely the virtual surgical plan (VSP) matches what actually happens during surgery.

For the study, they looked back at 35 patients who had two-jaw surgery guided by a 3D simulation. They calculated the difference between the planned and actual movement of certain points during surgery. This difference was measured in two ways: as an absolute value (abMAI) and as a proportion of the total distance the point moved (rMAI).

On average, the abMAI was 1.11mm, with a bigger difference found in the lower jaw (mandible) than in the upper jaw (maxilla). However, when they looked at rMAI, there was no significant difference between the two jaws. They also found that the total distance a point moved didn’t affect the rMAI.

They looked at several factors that could affect how closely the VSP matched reality. They found that patients with deformities related to clefts (gaps in the mouth or face) had less accurate VSPs than those without cleft-related deformities.

In simpler terms, this study shows how 3D simulation can be used in jaw surgery, and how to measure how well the plan matches what actually happens during the operation. It found that the method works pretty well, except in cases where the patient has a deformity related to a cleft.

FAQs

  1. How does 3D simulation help in orthognathic surgery?
  2. What factors could affect the accuracy of the Virtual Surgical Plan (VSP) in jaw surgery?
  3. Was there a significant difference found between the planned and actual movement in upper and lower jaw surgeries?

Doctor’s Tip

A helpful tip a doctor might tell a patient about jaw surgery is to trust the 3D simulation technology being used to plan the surgery. This study shows that the virtual surgical plan can be quite accurate in guiding the actual surgery, with only minor differences between the planned and actual movements of certain points in the jaw. Patients with cleft-related deformities may see slightly less accuracy in the virtual plan, but overall, 3D simulation is a valuable tool in ensuring a successful jaw surgery outcome. Trust in the technology and your healthcare team to guide you through the process.

Suitable For

Patients who are typically recommended for jaw surgery include those with:

  1. Severe malocclusion (misalignment of the jaws)
  2. Craniofacial anomalies
  3. Facial asymmetry
  4. Temporomandibular joint (TMJ) disorders
  5. Sleep apnea
  6. Difficulty chewing or speaking due to jaw misalignment.

Overall, jaw surgery is recommended for patients who have functional issues with their jaw alignment or have aesthetic concerns related to their facial structure.

Timeline

Before jaw surgery:

  1. Patient consults with a surgeon to discuss the need for jaw surgery and potential treatment options.
  2. Surgeon conducts a thorough examination, including imaging tests like CT scans or X-rays, to assess the current condition of the jaw and create a treatment plan.
  3. Virtual surgical planning (VSP) is done using 3D simulation technology to map out the exact movements and changes needed during surgery.
  4. Patient undergoes pre-operative preparation, which may include dental work, orthodontic treatment, and other necessary tests.
  5. Surgery is scheduled, and patient is informed about what to expect before, during, and after the procedure.

After jaw surgery:

  1. Patient undergoes the surgical procedure, which involves making precise incisions, repositioning the jaw bones, and securing them in place with plates and screws.
  2. Patient is closely monitored in the recovery room and may stay in the hospital for a few days for observation.
  3. Patient experiences swelling, pain, and discomfort in the days following surgery, and is prescribed pain medication and given instructions on how to care for the surgical site.
  4. Follow-up appointments are scheduled to monitor the healing process, adjust orthodontic appliances if needed, and track progress according to the VSP.
  5. Over time, the patient’s jaw gradually heals and aligns according to the planned changes, leading to improved function, aesthetics, and overall quality of life.

What to Ask Your Doctor

Questions a patient should ask their doctor about jaw surgery based on this research paper may include:

  1. How will 3D simulation be used in my jaw surgery procedure?
  2. Can you explain how the virtual surgical plan will be created and how it will guide the actual surgery?
  3. What measures will be taken to ensure that the planned movements in the virtual simulation match what actually happens during surgery?
  4. Will my specific condition, such as any cleft-related deformities, affect the accuracy of the virtual surgical plan?
  5. What factors will be considered to ensure the most accurate outcome in my jaw surgery?
  6. How will you measure the success of the virtual surgical plan during the actual surgery?
  7. Are there any potential risks or limitations associated with using 3D simulation in jaw surgery, based on this research?
  8. How will the findings of this research paper impact my specific jaw surgery procedure?
  9. Are there any alternative methods or technologies that could be considered for my jaw surgery?
  10. What steps will be taken to address any potential discrepancies between the virtual surgical plan and the actual surgery outcome?

Reference

Authors: Fawzy HH, Choi JW. Journal: J Craniomaxillofac Surg. 2019 Jun;47(6):860-866. doi: 10.1016/j.jcms.2019.03.005. Epub 2019 Mar 13. PMID: 30914227