EVALUATING THE ACCURACY OF SURGICAL PREDICTION UTILIZING COMPUTER-ASSISTED SURGICAL SIMULATION IN MULTI-PIECE LE FORT I SURGERY WITH SINGLE SPLINT TECHNIQUE (A PRELIMINARY STUDY)

Abstract

Multi-piece Le Fort I maxillary surgery using a single-splint technique reduces treatment time, yet specific accuracy evaluations of 3D Computer-Assisted Surgical Simulation (CASS) for this approach remain lacking. This article reports an interim analysis of an ongoing prospective study assessing the coordinate accuracy of this technique. Data were analyzed from the first 4 subjects (out of a target sample of 13) by comparing preoperative and 3-month postoperative cone-beam computed tomography (CBCT) scans using voxel-based cranial base registration. Seven skeletal and dental anatomical landmarks, totaling 21 variables, were measured. Results revealed no statistically significant differences between the planned and actual postoperative positions across all 21 variables (p  0.066). Regarding clinical significance (RMSD < 2 mm), the coronal plane met the criteria at all landmarks (7/7). The Frankfort horizontal plane met the criteria at 6 of 7 landmarks (exceeding at the left canine; RMSD = 2.31 mm). The midsagittal plane met the criteria at 5 of 7 landmarks (exceeding at the left canine; RMSD = 2.10 mm, and left first molar; RMSD = 2.51 mm). In conclusion, CASS combined with the single-splint technique demonstrates a promising trend of overall accuracy, although the greatest clinical deviations occurred near the osteotomy sites at the canines and posterior molars. These findings serve as pilot data, and further data collection is currently ongoing to achieve the required sample size.

Keywords: Orthognathic Surgery, Computer-Assisted Surgical Simulation, Single Splint Technique, Preliminary Study