Digital dental splints in orthognathic surgery and evaluation of their accuracy of fit in an anatomically articulated model

Nambinayaki, E M (2018) Digital dental splints in orthognathic surgery and evaluation of their accuracy of fit in an anatomically articulated model. Masters thesis, Ragas Dental College and Hospital, Chennai.


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PURPOSE: The purpose of this prospective clinical study is to evaluate the accuracy of fit of digital dental splints in an anatomically articulated model on which model surgery is performed. The intermediate 3D printed splints were verified in an anatomical articulator. MATERIALS AND METHODS: A total of 4 patients (Table 1,2) who were willing to undergo orthognathic surgery (Graph 2) were included in this study. The methodology of the study were as follows: A Cone Beam Computed Tomography scan was obtained with fiducial titanium markers of standardized dimensions glued to the attached gingiva (Figure 57) for all patients excluding one patient for whom a medical Computed Tomography scan was taken. The upper and lower impressions were made, and models prepared (Figure 58). These dental casts were scanned with an optical scanner and the digital dental casts were saved as stl files (Figure 56 A, B). The CBCT scans and the digital dental scans were imported into MIMICS software (Version 17.0 Leuven, Belgium). Planned virtual osteotomy was performed virtually on the 3D reconstructed models after accurate superimposition based on the fiducial titanium markers (Figure 30,31). Intermediate splints were virtually designed (Figure 36,37,38), and 3D printed by importing into 3D printer (Inkjet printing) in our study. RESULTS: Out of the four patients, one patient with Hemifacial Microsomia had extensive bleeding during a medial cut on the mandibular ramus due to which the planned mandibular surgery was not performed. One patient was previously treated for temporomandibular joint ankylosis, who had no complications intra-operatively during orthognathic surgery. The fit of the digital dental splint was subjectively superior to the conventional acrylic splints and therefore was clinically more acceptable. CONCLUSION: The results of this study indicates that virtual planning and 3D printing of the intermediate splints have the following advantages: 1. An overall decrease in the time required for conventional planning in orthognathic surgery. 2. Aids in better understanding of the existing deformity in all dimensions. 3. Ensures more accuracy in splint fabrication, aiding in superior precision in positioning of the osteotomized segments. 4. Minimizes the errors due to conventional two-dimensional radiographs. 5. The use of fiducial markers in our study makes the superimposition process more accurate and avoids inaccuracies due to superimposition.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Cone Beam Computed Tomography, Orthognathic Surgery, Virtual Planning, Digital Splints, Fiducial Titanium Markers.
Subjects: DENTAL > Oral and Maxillofacial Surgery
Depositing User: Subramani R
Date Deposited: 24 Oct 2018 03:31
Last Modified: 24 Oct 2018 03:31

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