Accuracy of CAD/CAM Cutting Guides and Customized Titanium Plates for Virtual Planning Transfer Compared to Classic Model Surgery in Bi-maxillary Orthognathic Surgeries. A Randomized Controlled Clinical Trial

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Mohamed Ali Zain, Maha Mohamed Hakam, Adel Hamdy Abo El-Fotouh, Mahmoud Hanafy Mahmoud

Abstract

Purpose: To evaluate the accuracy of CAD/CAM cutting guides and customized titanium plates in transferring the virtual plan in comparison to classic model surgery approach in bimaxillary orthognathic surgeries.


Methods: A total of 18 patients indicated for bi-maxillary orthognathic surgery were randomly assigned to 2 equal parallel groups; 9 patients were treated by CAD/CAM cutting guides and customized titanium plates (group 1) and 9 patients were treated using classic model surgery (group 2). Accuracy of transfer was assessed for each group.


Results: Maxillary mediolateral linear deviation in group 1 showed statistically significant lower values than that in group 2. While mandibular vertical and anteroposterior linear deviation in group 1 showed statistically significant lower values than that in group 2. While for other planes and measurements, the differences in accuracy between the two groups were statistically insignificant (p>0.05).


Conclusion: Computer-guided orthognathic surgery workflow provided more accuracy compared to classic model surgery. However both groups showed significant deviation from the virtual plan. Minor inaccuracies occurred in both groups did not affect the clinical outcome and patient quality of life in the included sample.

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