“Hemimandibular Hyperplasia Correction by Simultaneous Orthognathic Surgery and Condylectomy under Digital Guidance”

Publication date: Available online 15 March 2018
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Bing Han, Xing Wang, Zili Li, Biao Yi, Cheng Liang, Xiaoxia Wang
BackgroundSimultaneous orthognathic surgery and condylectomy under digital guidance has been proven to be a feasible method to treat hemimandibular hyperplasia (HH). The objective of this study was to evaluate effects and precision of correction of HH by use of this method.MethodsThis was a case-series study. Fourteen patients with HH who had undergone simultaneous bimaxillary orthognathic surgery and condylectomy from January 2016 to April 2017 were included in this study. Presurgical virtual treatment planning was performed, transferred to the operation room, and realized with assistance of surgical navigation and 3 dimensionally printed occlusion splints. Postoperative CT data were used to analyze improvement of facial symmetry and verify accuracy of the surgical procedure.ResultsAll patients exhibited satisfactory clinical effects: facial asymmetry was corrected as expected. Postoperative validation revealed that the presurgical planning had been achieved more precisely on the unaffected side than on the affected side. Moreover, bilateral mandibular proximal segments revealed a tendency of outward rotation compared with the presurgical planning model. Furthermore, when assessing facial symmetry compared with the presurgical model, deviation of all midline landmarks was <2 mm, occlusal plane inclination was <1 mm, and asymmetry index of paired landmarks remarkably decreased after surgery (p<0.01).ConclusionSimultaneous orthognathic surgery and condylectomy under digital guidance is a realistic and precise method for treatment of HH. Surgical results can be validated during surgery by virtual navigation. However, movement of each bone segment cannot be accurately controlled as planned before surgery.



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