Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study

Abstract Background The aim of this study was to compare the accuracy of 3D-printed intermediate wafers (3DW) with conventionally made intermediate wafers (CW) fabricated through manual model surgery (MMS). This study was designed as an in vitro experiment focused on the Le Fort I osteotomy and maxi...

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Main Authors: Junho Jung, Jongseok Shin, Joo-Young Ohe, Byung-Joon Choi
Format: Article
Language:English
Published: BMC 2025-05-01
Series:Head & Face Medicine
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Online Access:https://doi.org/10.1186/s13005-025-00516-7
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author Junho Jung
Jongseok Shin
Joo-Young Ohe
Byung-Joon Choi
author_facet Junho Jung
Jongseok Shin
Joo-Young Ohe
Byung-Joon Choi
author_sort Junho Jung
collection DOAJ
description Abstract Background The aim of this study was to compare the accuracy of 3D-printed intermediate wafers (3DW) with conventionally made intermediate wafers (CW) fabricated through manual model surgery (MMS). This study was designed as an in vitro experiment focused on the Le Fort I osteotomy and maxillary repositioning process. It aims to achieve maxillary repositioning outcomes mediated by intermediate wafers while eliminating intraoperative errors. Materials and methods Both MMS and virtual model surgery (VMS) were performed for each patient to fabricate CW and 3DW. Subsequently, the maxillomandibular dental casts were remounted on the articulator using the fabricated CW and 3DW, followed by digital scanning and superimposition. The midpoint of the right maxillary central incisor edge, the uppermost points of the right and left maxillary canines, and the mesiobuccal cusps of the right and left maxillary molars were used as measurement points. The points in VMS were set as references for comparison. Paired t-tests were conducted to compare the outcomes between CW and 3DW. Independent t-tests were used to analyze differences between groups with and without rotational movements. Additionally, Spearman’s correlation analysis was performed to examine the relationship between the rotational movement of the maxilla and the corresponding coordinate differences. Results Significant differences were observed in the transverse (p = 0.005), anteroposterior (p = 0.016), and vertical (p = 0.003) coordinates between the maxillary positions derived from CW and VMS. In MMS, the presence of roll movement significantly influenced transverse position (p = 0.002), pitch affected vertical position (p < 0.001), and yaw impacted transverse (p = 0.005) and vertical (p = 0.019) positions. Conclusion 3DW demonstrated greater accuracy than MMS with CW. Especially in cases involving rotational maxillary movements such as roll, yaw, and pitch, it resulted in fewer errors compared to MMS with CW. Consequently, 3DW offers more precise recording of maxillary repositioning plan and contributes to the successful transfer of this plan into the surgical outcome in orthognathic surgery.
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spelling doaj-art-2346d591c1dd45ae8d0cdd9cfdca8a962025-08-20T03:53:14ZengBMCHead & Face Medicine1746-160X2025-05-0121111010.1186/s13005-025-00516-7Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro studyJunho Jung0Jongseok Shin1Joo-Young Ohe2Byung-Joon Choi3Department of Oral & Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Medical CenterDepartment of Oral & Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Medical CenterDepartment of Oral & Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Medical CenterDepartment of Oral & Maxillofacial Surgery, Kyung Hee University College of Dentistry, Kyung Hee University Medical CenterAbstract Background The aim of this study was to compare the accuracy of 3D-printed intermediate wafers (3DW) with conventionally made intermediate wafers (CW) fabricated through manual model surgery (MMS). This study was designed as an in vitro experiment focused on the Le Fort I osteotomy and maxillary repositioning process. It aims to achieve maxillary repositioning outcomes mediated by intermediate wafers while eliminating intraoperative errors. Materials and methods Both MMS and virtual model surgery (VMS) were performed for each patient to fabricate CW and 3DW. Subsequently, the maxillomandibular dental casts were remounted on the articulator using the fabricated CW and 3DW, followed by digital scanning and superimposition. The midpoint of the right maxillary central incisor edge, the uppermost points of the right and left maxillary canines, and the mesiobuccal cusps of the right and left maxillary molars were used as measurement points. The points in VMS were set as references for comparison. Paired t-tests were conducted to compare the outcomes between CW and 3DW. Independent t-tests were used to analyze differences between groups with and without rotational movements. Additionally, Spearman’s correlation analysis was performed to examine the relationship between the rotational movement of the maxilla and the corresponding coordinate differences. Results Significant differences were observed in the transverse (p = 0.005), anteroposterior (p = 0.016), and vertical (p = 0.003) coordinates between the maxillary positions derived from CW and VMS. In MMS, the presence of roll movement significantly influenced transverse position (p = 0.002), pitch affected vertical position (p < 0.001), and yaw impacted transverse (p = 0.005) and vertical (p = 0.019) positions. Conclusion 3DW demonstrated greater accuracy than MMS with CW. Especially in cases involving rotational maxillary movements such as roll, yaw, and pitch, it resulted in fewer errors compared to MMS with CW. Consequently, 3DW offers more precise recording of maxillary repositioning plan and contributes to the successful transfer of this plan into the surgical outcome in orthognathic surgery.https://doi.org/10.1186/s13005-025-00516-7Manual model surgeryVirtual model surgeryWafer fabricationMaxillary repositioningOrthognathic surgery
spellingShingle Junho Jung
Jongseok Shin
Joo-Young Ohe
Byung-Joon Choi
Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
Head & Face Medicine
Manual model surgery
Virtual model surgery
Wafer fabrication
Maxillary repositioning
Orthognathic surgery
title Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
title_full Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
title_fullStr Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
title_full_unstemmed Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
title_short Comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning: an in vitro study
title_sort comparison of manual and virtual model surgery for wafer fabrication in maxillary repositioning an in vitro study
topic Manual model surgery
Virtual model surgery
Wafer fabrication
Maxillary repositioning
Orthognathic surgery
url https://doi.org/10.1186/s13005-025-00516-7
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AT jooyoungohe comparisonofmanualandvirtualmodelsurgeryforwaferfabricationinmaxillaryrepositioninganinvitrostudy
AT byungjoonchoi comparisonofmanualandvirtualmodelsurgeryforwaferfabricationinmaxillaryrepositioninganinvitrostudy