The Use of Surgical Splints in Orthognathic Surgery: A Bibliometric Study

Abstract Introduction Orthognathic surgeries require the use of surgical splints (SS) to stabilize the occlusion and the segments fixed with plates and screws. Technological advances in the field of computing and the possibility of generating three-dimensional (3D) images have brought different possibilities for making SS, which has generated greater predictability and customization of surgical plans. The bibliometric study can have a qualitative character through the scope of articles in a certain area of knowledge. It is a selection process that can track a topic or scientific production. Methods The present study aimed to carry out a bibliometric literature review, in order to assess the evolution of the use of SS and the different planning protocols in orthognathic surgery. The Scopus database was used, with the terms “splint” and “orthognathic surgery.” Results A total of 331 articles were found. These were exported to Rayyan for application of the inclusion and exclusion criteria and selection of articles. A total of 76 references were selected and exported to the VOSviewer application for the analysis of bibliometric data. Conclusions Orthognathic surgery was initially not associated with any computerized technological resource; however, it underwent updates between the years 2010 to 2012. These advances allowed surgical planning to become faster, cheaper, and more accurate.

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Orthognathic Surgery of the Mandible

Facial Plastic Surgery ◽

10.1055/s-0041-1735309 ◽

2021 ◽

Author(s):

Sara Bahmanyar ◽

Arya W. Namin ◽

Robert O. Weiss ◽

Aurora G. Vincent ◽

Andrew M. Read-Fuller ◽

...

Keyword(s):

Soft Tissue ◽

Surgical Technique ◽

Orthognathic Surgery ◽

Orthodontic Treatment ◽

Surgical Planning ◽

Surgical Techniques ◽

Preoperative Assessment ◽

Virtual Surgical Planning ◽

Facial Esthetics ◽

Technological Advances

AbstractOrthognathic surgery performed in conjunction with orthodontic treatment is commonly performed to correct skeletal irregularities and realign the maxillomandibular relationship to improve occlusal function and facial esthetics. A thorough understanding of soft tissue esthetics, skeletal and occlusal relationships, and surgical techniques is required to obtain successful results. Surgical techniques have evolved greatly throughout history, as technological advances such as virtual surgical planning have become available and widely used to obtain predictable movements with minimized complications. The aim of this article is to review the orthognathic surgical procedures of the mandible, with particular attention to the indications, contraindications, preoperative assessment, surgical technique, and possible complications encountered.

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Three-dimensional virtual-reality surgical planning and soft-tissue prediction for orthognathic surgery

IEEE Transactions on Information Technology in Biomedicine ◽

10.1109/4233.924800 ◽

2001 ◽

Vol 5 (2) ◽

pp. 97-107 ◽

Cited By ~ 64

Author(s):

James Xia ◽

H.H.S. Ip ◽

N. Samman ◽

H.T.F. Wong ◽

J. Gateno ◽

...

Keyword(s):

Virtual Reality ◽

Soft Tissue ◽

Orthognathic Surgery ◽

Surgical Planning ◽

Three Dimensional

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Three dimensional rotational angiography in surgical planning of aneurysm clipping

VASA ◽

10.1024/0301-1526/a000134 ◽

2011 ◽

Vol 40 (5) ◽

pp. 375-380 ◽

Cited By ~ 1

Author(s):

Petridis ◽

Doukas ◽

Niu ◽

Barth ◽

Maslehaty ◽

...

Keyword(s):

Surgical Planning ◽

Preoperative Planning ◽

Three Dimensional ◽

Aneurysm Rupture ◽

3D Images ◽

Aneurysm Clipping ◽

3D Angiography ◽

Subarachnoid Bleeding ◽

Aneurysm Wall ◽

Anterior Circle

Background: Three-dimensional (3D) angiography is increasingly used in the diagnostics of brain aneurysms. Aim of the present study was to evaluate the accuracy of 3D angiograms with respect to its value for preoperative planning of aneurysm clipping. Patients and methods: The 3D angiograms of 42 patients with subarachnoid bleeding caused by aneurysm rupture of the anterior circle of Willis and the intradural carotid have been compared to intraoperative photographs of the aneurysms. Results: Neighbouring vessels, aneurysm anatomy, arteries originating from the aneurysm wall were accurately shown decreasing the surgical risk of aneurysm clipping. Conclusions: The 3D images enabled a perfect preoperative planning through the operation by illuminating the aneurysm anatomy, neck localisation and shape and relation of the aneurysm to neighbouring vessels. Operative approach, use of an accurate clip and avoidance of clipping arteries close to the aneurysm have become predictable and safer by the use of 3D angiography.

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P126: Development of inclusion and exclusion criteria for ECPR in a regional hospital

CJEM ◽

10.1017/cem.2018.324 ◽

2018 ◽

Vol 20 (S1) ◽

pp. S101-S101

Author(s):

D. Rollo ◽

P. Atkinson ◽

J. Fraser ◽

J. Mekwan ◽

J. P. French ◽

...

Keyword(s):

Selection Criteria ◽

Selection Process ◽

Selection Criterion ◽

Flow Time ◽

Regional Hospital ◽

Current Evidence ◽

Inclusion Criteria ◽

Exclusion Criteria ◽

Patient Selection Criterion ◽

Selection Of

Introduction: Extracorporeal cardiopulmonary resuscitation (ECPR), a method of cardiopulmonary bypass, is increasingly being used to supplement traditional CPR to improve outcomes for cardiac arrest (CA). CA and particularly out of hospital CA (OHCA) have poor outcomes. Prior to development of a 3 phase ECPR program in a Canadian regional hospital, we wished to identify and optimize a practical selection process (inclusion and exclusion criteria) for patients who may benefit from ECPR. Methods: Using a locally modified Delphi technique, we followed a literature review to construct a proposed set of evidence based criteria with a questionnaire, where inclusion and exclusion criteria were scored by a selected group of 13 experts. Following 3 rounds, and additional review by an international expert in the field of ECPR, consensus was achieved for patient selection criterion. Results: First round responses achieved 87.5% agreement for selection of exclusion criteria. Inclusion criteria had agreement 62.5%. Responses to the second round for selection of inclusion criteria were unanimous at 100% with the exception of age parameters (<65 years vs. <70 years). The third and final set of criteria achieved 100% consensus though subsequent expert review refined a single exclusion criteria (asystole). Agreed inclusion criteria were: witnessed CA, age <70, refractory arrest, no flow time <10min, total downtime <60min, and a cardiac or select non-cardiac etiology (PE, drug OD, poisoning, hypothermia). Exclusion criteria were : unwitnessed arrest, asystole, certain etiologies (uncontrolled bleeding, irreversible brain damage, trauma), and comorbidities (severe disability limiting ADLs, standing DNR, palliation). Simplified criteria for EMS transport included witnessed OHCA, age, and no flow time. Conclusion: Selection criteria of candidates for ECPR are important components for any program. Expert consensus review of current evidence is an effective method for development of ECPR selection criteria.

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PSI-Guided Mandible-First Orthognathic Surgery: Maxillo-Mandibular Position Accuracy and Vertical Dimension Adjustability.

10.21203/rs.3.rs-145748/v1 ◽

2021 ◽

Author(s):

Giovanni Badiali ◽

Mirko Bevini ◽

Ottavia Lunari ◽

Elisa Lovero ◽

Federica Ruggiero ◽

...

Keyword(s):

Orthognathic Surgery ◽

Surgical Planning ◽

Three Dimensional ◽

Patient Specific ◽

Pitch Range ◽

Surgery Patient ◽

Novel Approach ◽

Mandibular Position ◽

3D Printed

Abstract In orthognathic surgery, patient-specific osteosynthesis implants (PSIs) represent a novel approach for the reproduction of the virtual surgical planning on the patient. The aim of this study is to analyse the quality of maxillo-mandibular positioning using a hybrid mandible-first mandibular-PSI guided procedure on twenty-two patients while the upper maxilla was fixed using manually-bent stock titanium miniplates. The virtual surgical plan was used to guide the design of PSIs and positioning guides, which were then 3D printed using biocompatible materials. A CBCT scan was performed one month after surgery and postoperative facial skeletal models were segmented for comparison against the surgical plan. A three-dimensional cephalometric analysis was carried out on both planned and obtained anatomies. A Spearman correlation matrix was computed on the calculated discrepancies, in order to achieve a more comprehensive description of maxillo-mandibular displacement. Intraoperatively, all PSIs were successfully applied. The procedure was found to be accurate in planned maxillo-mandibular positioning reproduction, while maintaining a degree of flexibility to allow for aesthetics-based verticality correction in a pitch range between-5.31 and +1.79 mm. Such correction did not significantly affect the achievement of planned frontal symmetry.

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Automatic Selection of Mechanism Designs from a Three-Dimensional Design Map

Journal of Mechanical Design ◽

10.1115/1.2926561 ◽

1992 ◽

Vol 114 (3) ◽

pp. 359-367 ◽

Cited By ~ 10

Author(s):

S. Kota

Keyword(s):

Selection Process ◽

Three Dimensional ◽

Quantitative Comparison ◽

Linkage Mechanism ◽

Computer Aided ◽

Definite Pattern ◽

Design Selection ◽

Four Bar Linkage ◽

Synthesis Approach ◽

Selection Of

Often a simple (four-bar linkage) mechanism to trace a desired path is sought. Dimensions of linkages to trace a specified coupler curve exactly are difficult to determine. Precision point techniques do not guarantee that the desired path will be generated. The methodology presented in this paper is based on indirect synthesis approach to select four-bar linkages that trace a given desired path. A practical, computer-aided three-dimensional design chart for the selection of four-bar linkage candidate designs that trace symmetrical paths is presented. It is based on hypothesis that any arbitrary path can be approximated by a symmetrical path at least for the purpose of choosing an initial design. Four-bar linkages that generate symmetrical paths are easier to design and exhibit a definite pattern of changes in their shape as the linkage parameters are varied. General design categories and the corresponding solution subspaces in the 3-D design map are identified to aid in the selection of candidate designs. The automation of the design-selection process requires a satisfactory means to quantitatively compare the “desired” and the “known” coupler curves. This paper addresses the issues involved in quantitative comparison of two arbitrary curves using parameterization and shape evaluation. A design example of automated selection of mechanism designs is also presented.

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Segmentation and Three Dimensional Visualization of Mandible Using Active Contour and Visualization Toolkit in Craniofacial Computed Tomography Images

Journal of Computational and Theoretical Nanoscience ◽

10.1166/jctn.2020.8630 ◽

2020 ◽

Vol 17 (1) ◽

pp. 61-67

Author(s):

Jithy Varghese ◽

Tripty Singh ◽

Venkatraman Bhat ◽

Moni Kuriakose

Keyword(s):

Computed Tomography ◽

Orthognathic Surgery ◽

Active Contour ◽

Surgical Planning ◽

Three Dimensional ◽

Bone Surface ◽

Facial Bone ◽

Virtual Surgical Planning ◽

Computed Tomography Images ◽

Segmentation Accuracy

Three-dimensional representation of facial bone surface is needed in the virtual surgical planning for orthognathic surgery. Segmentation of facial bone surface from computed tomography images is first step in developing the 3D model. This paper focuses on segmentation of mandible bone using active contour segmentation of Insight Segmentation and Registration Toolkit library. The results are given as 3D stereo lithographic image. The result is compared with the ground truth image segmented by an expert radiologist. Various evaluation metrics are used for finding the segmentation accuracy and the result has given segmentation accuracy of 97.50%. Therefore, this method can be used as an initial step in automatic cephalometric land marking, an important task in virtual surgical planning for orthognathic surgery.

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Three-dimensional virtual surgical planning (3D-VSP) in orthognathic surgery: Advantages, disadvantages and pitfalls

Journal of Orthodontics ◽

10.1177/1465312520954871 ◽

2020 ◽

pp. 146531252095487

Author(s):

Chris D Donaldson ◽

Mehmet Manisali ◽

Farhad B Naini

Keyword(s):

Computer Aided Design ◽

Orthognathic Surgery ◽

Surgical Planning ◽

Three Dimensional ◽

Open Bite ◽

Anterior Open Bite ◽

Skeletal Class ◽

Virtual Surgical Planning ◽

Skeletal Class Ii ◽

Computer Aided

In this article, the advantages, disadvantages and pitfalls of three-dimensional virtual surgical planning (3D-VSP) compared to traditional two-dimensional (2D) planning methods in orthognathic surgery are discussed, alongside a standardised protocol that can be utilised. A skeletal Class II, skeletal Class III and an anterior open bite clinical case along with their 3D-VSP management are presented, highlighting modifications that can be made to computer-aided design/computer-aided manufacture (CAD/CAM) cutting guide and plate designs.

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PSI-Guided Mandible-First Orthognathic Surgery: Maxillo-Mandibular Position Accuracy and Vertical Dimension Adjustability

Journal of Personalized Medicine ◽

10.3390/jpm11111237 ◽

2021 ◽

Vol 11 (11) ◽

pp. 1237

Author(s):

Giovanni Badiali ◽

Mirko Bevini ◽

Ottavia Lunari ◽

Elisa Lovero ◽

Federica Ruggiero ◽

...

Keyword(s):

Orthognathic Surgery ◽

Surgical Planning ◽

Three Dimensional ◽

Patient Specific ◽

Pitch Range ◽

Surgery Patient ◽

Novel Approach ◽

Mandibular Position ◽

3D Printed

In orthognathic surgery, patient-specific osteosynthesis implants (PSIs) represent a novel approach for the reproduction of the virtual surgical planning on the patient. The aim of this study is to analyse the quality of maxillo-mandibular positioning using a hybrid mandible-first mandibular-PSI-guided procedure on twenty-two patients while the upper maxilla was fixed using manually bent stock titanium miniplates. The virtual surgical plan was used to design PSIs and positioning guides, which were then 3D printed using biocompatible materials. A Cone Beam Computed Tomography (CBCT) scan was performed one month after surgery and postoperative facial skeletal models were segmented for comparison against the surgical plan. A three-dimensional cephalometric analysis was carried out on both planned and obtained anatomies. A Spearman correlation matrix was computed on the calculated discrepancies in order to achieve a more comprehensive description of maxillo-mandibular displacement. Intraoperatively, all PSIs were successfully applied. The procedure was found to be accurate in planned maxillo-mandibular positioning reproduction, while maintaining a degree of flexibility to allow for aesthetics-based verticality correction in a pitch range between −5.31 and +1.79 mm. Such a correction did not significantly affect the achievement of planned frontal symmetry.

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Predictability and Accuracy between 3D Virtual Surgical Planning and Actual Outcomes in Orthognathic Surgery

10.53902/mrprs.2021.01.000509 ◽

2021 ◽

Vol 1 (2) ◽

Author(s):

Pampín Martínez MM

Keyword(s):

Orthognathic Surgery ◽

Surgical Planning ◽

3D Models ◽

Free Software ◽

Postoperative Results ◽

Virtual Planning ◽

Postoperative Result ◽

Virtual Surgical Planning ◽

Technological Advances ◽

The Difference

Introduction: We are living a paradigm shift in orthognathic surgery. Several tools and technological advances are being implemented to help improve surgical experience and to offer better functional and aesthetical results. Virtual surgical planning is a revolutionary tool which helps us design the surgical plan preoperatively and establish a surgical protocol specifically designed for that patient. In this study, our goal is to validate the predictability of virtual surgical planning in orthognathic surgery, comparing the final results with the virtual plan. Material and methods: We performed an ICP based super imposition of 3D models of the virtual planning preoperatively designed and the 3D model of the postoperative CBCT using free software (Slicer) in patients who underwent bimaxillary orthognathic surgery. The results of the super imposition were saved on the postoperative model and presented as a color-coded map. This was generated as a .vtk file that was exported to another free software that displayed the difference in mm in relevant cephalometric points (point A, point B, pogonion, left and right gonion and first upper molars) in the three axis (x, y and z) between the postoperative result and the virtual plan. Then, we registered these results for all patients and analysed these data. Results: A total of 41 patients were included. The median of the differences in mm between virtual planning and postoperative results were less than 1mm for all cephalometric points, except for both gonion, where greater than 1mm differences were found in the mediolateral (horizontal) direction. For the rest of landmarks, the highest differences were found at A point and pogonion in the anteroposterior direction (0,83mm and 0,78mm, respectively). Conclusions: We found overall small and tolerable differences (<1mm) between the planned movements and the postoperative results. The highest were found at the gonion in the mediolateral direction and mandibular rami, which could be explained by the torque of the proximal segment. The differences in A point and pogonion in the anteroposterior direction were the highest among the rest, which may be related to inaccuracy of the splint in this direction.

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