One-Jaw versus Two-Jaw Orthognathic Surgery for Patients with Cleft: A Comparative Study Using 3D Imaging Virtual Surgical Planning

Applied Sciences

Cheng-Ting Ho¹  Betty C. J. Pai¹  Hsiu-Hsia Lin²  Yu-Hung Tsai³  Lun-Jou Lo⁴ 

[1] Craniofacial Orthodontics, Department of Dentistry, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan;Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan;Department of Dentistry, Fu-Jen Catholic University Hospital, New Taipei 242, Taiwan;Plastic & Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan 333, Taiwan;

关键词: cleft lip palate;    orthognathic surgery;    one-jaw;    two-jaw;    3D imaging;    virtual surgery planning;   

DOI  :  10.3390/app12094461

来源: DOAJ

【 摘 要 】

Whether a one-jaw or two-jaw design is used in orthognathic surgery for patients with cleft remains varied and controversial. This study aimed to compare the two approaches using 3-dimensional imaging surgical simulation. This study was conducted on 41 consecutive patients with complete unilateral cleft lip and palate treated in the craniofacial center. All patients had original two-jaw virtual planning and orthognathic surgery. Simulation of one-jaw LeFort I surgery was performed using the same final dental occlusion on 3-dimensional images. Cephalometric data and asymmetry index were collected and compared among the designs. Average advancement of the maxilla was 7.46 mm in one-jaw and 4.80 mm in two-jaw design. SNA, SNB, and A-N perpendicular were significantly greater and close to normative data in the one-jaw design. ANB angles were similar in both designs. The anterior and posterior occlusal plane cants, the deviation of midline landmarks, and the asymmetry index were more improved in the two-jaw approach. It is concluded that the two-jaw cleft orthognathic surgery could significantly improve facial midline and symmetry compared with the one-jaw approach. However, the two-jaw surgery with mandibular setback produced less protrusive facial contour although a harmonious relationship between the maxilla and mandible was achieved.

【 授权许可】

Unknown