Maxillary repositioning using a CAD/CAM wafer and an intraoperative navigation system for bimaxillary orthognathic surgery using segmental Le Fort I osteotomy: A pilot study

Objective: The precision of maxillary repositioning using computer-aided design/computer-aided manufacturing (CAD/CAM)-generated wafers and a surgical navigation system for bimaxillary orthognathic surgery (BMOS) using segmental Le Fort I osteotomy was evaluated. Methods: Six participants with jaw deformities who required BMOS incorporating segmental Le Fort I osteotomy were included. The preoperative simulation was performed using a three-dimensional skull model on the simulation software, and a wafer for maxillary repositioning was prepared by CAD/CAM. Using the CAD/CAM-generated wafer and intraoperative navigation system, the maxillary segments were repositioned to agree with virtual surgical planning. The ideal movements of the preoperative simulation were compared with the actual movements after the surgery, and the errors of the ideal movements with reference to the actual movements were evaluated three-dimensionally at seven evaluation points. Results: The largest and smallest median errors calculated from the differences between the ideal and actual 3-D movements were, respectively, 0.65 mm at anterior nasal spine, 0.02 mm at posterior nasal spine. There is no significant difference was observed between ideal and actual movements in either 2-D and 3-D. Conclusion: The clinical accuracy of maxillary repositioning with the CAD/CAM wafer and an intraoperative navigation system in segmental Le Fort I osteotomy was revealed in the present study. (C) 2021 Asian AOMS, ASOMP, JSOP, JSOMS, JSOM, and JAMI. Published by Elsevier Ltd. All rights reserved.