Int J Stomatol

Int J Stomatol ›› 2021, Vol. 48 ›› Issue (2): 156-164.doi: 10.7518/gjkq.2021024

• Original Articles • Previous Articles     Next Articles

Research and accuracy of different methods of digital occlusal splint fabrication for orthognathic surgery

Wang Lidong(),Ma Wen,Fu Shuai,Zhang Changbin,Cui Qingying,Liang Yan,Li Ming()   

  1. Dept. of Oral and Maxillofacial Sur-gery, Affiliated Stomatological Hospital of Kunming Medical University, Kunming 650000, China
  • Received:2020-06-15 Revised:2020-11-20 Online:2021-03-01 Published:2021-03-17
  • Contact: Ming Li E-mail:1141657618@qq.com;1020513890@qq.com
  • Supported by:
    Applied Basic Research Foundation of Yunnan Province (Applied Basic Research Foundation of Kunming Medical University)(2017FE467（-193）)

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Abstract:

Objective To explore different methods of digital occlusal splint fabrication for orthognathic surgery and evaluate their accuracy and clinical application value. Methods Ten patients at the Department of Oral and Maxillofacial Surgery of Affiliated Stomatological Hospital of Kunming Medical University with dental and maxillofacial deformities were selected from June 2017 to February 2019. Pre-operative simulation design, virtual osteotomy, and digital occlusal splint design were conducted using single and multiple software, and the accuracy and working time of the resulting digital occlusal splints were evaluated. A traditional occlusal splint was also manufactured by plaster model surgery to evaluate the accuracy and clinical application value of single-software digital occlusal splints. Results The average maximum fusion error of the single-software digital occlusal splint was (0.011 1±0.003 8) mm in the maxilla and (0.010 7±0.003 7) mm in the mandible. The maximum fusion error of the single-software digital occlusal splint was better than that of the multi-software digital occlusal splint (P<0.001), and no significant difference between the maxilla and mandible was observed (P>0.05). There was no case that the occlusal splint can,t be brought in during the operation. The simulation time of single-software operation was less than that of multi-software operation in both single- and double-jaw operations. Conclusion Digital occlusal splints prepared by different methods show different levels of accuracy. Single-software digital occlusal splints offer higher accuracy than multi-software digital occlusal splints. Moreover, the simulation time of single-software operation is less than that of multi-software operation. Thus, single-software digital occlusal splints have great practical application value.

Key words: orthognathic surgery, computer aided technology, cone beam computed tomography, three-dimensio-nal reconstruction, occlusal splint

CLC Number: 

  • R622

TrendMD: 

Fig 1

3D reconstruction maxillary and mandibular models in ProPlan CMF 1.4"

Fig 2

Composite model with the accuracy of dental surface by fusing plaster model"

Fig 3

Maxilla and mandible was moved to planned position after simulated surgery"

Fig 4

Design and manufacture of single software digital occlusal splint"

Fig 5

Digital occlusal splint model and entity"

Fig 6

Fusing error between single software vs standard group and multi-software vs standard group in maxilla and mandible"

Tab 1

Error comparison between single software vs standard group and multi-software vs standard group"

组别 例数/例 （均值±标准差）/mm t值 P值
总体 单软件vs标准 38 0.001 1±0.003 7 -32.36 <0.001
多软件vs标准 38 0.131 0±0.022 6
上颌 单软件vs标准 19 0.011 1±0.003 8 -25.18 <0.001
多软件vs标准 19 0.133 3±0.020 8
下颌 单软件vs标准 19 0.010 7±0.003 7 -20.69 <0.001
多软件vs标准 19 0.128 8±0.024 6
单软件VS标准 上颌 19 0.011 1±0.003 8 0.58 0.567
下颌 19 0.010 7±0.003 7
多软件VS标准 上颌 19 0.133 3±0.020 8 0.67 0.511
下颌 19 0.128 8±0.024 6

Fig 7

Intraoperative contrast"

Tab 2

Operative methods and results of intraoperative plate comparison"

手术方式 例数/例 结果
BSSRO 1 牙合板无偏差
Le Fort Ⅰ型截骨+BSSRO 7 牙合板无偏差
Le Fort Ⅰ型截骨+BSSRO+颏成形术 2 牙合板无偏差
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