Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery
Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital...
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MDPI AG
2025-07-01
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| author | Álvaro Pérez-Sala Pablo Montes Fernández-Micheltorena Miriam Bobadilla Ricardo Fernández-Valadés Gámez Javier Martínez Goñi Ángela Villanueva Iñigo Calvo Archanco José Luis Del Castillo Pardo de Vera José Luis Cebrián Carretero Carlos Navarro Cuéllar Ignacio Navarro Cuellar Gema Arenas Ana López López Ignacio M. Larrayoz Rafael Peláez |
| author_facet | Álvaro Pérez-Sala Pablo Montes Fernández-Micheltorena Miriam Bobadilla Ricardo Fernández-Valadés Gámez Javier Martínez Goñi Ángela Villanueva Iñigo Calvo Archanco José Luis Del Castillo Pardo de Vera José Luis Cebrián Carretero Carlos Navarro Cuéllar Ignacio Navarro Cuellar Gema Arenas Ana López López Ignacio M. Larrayoz Rafael Peláez |
| author_sort | Álvaro Pérez-Sala |
| collection | DOAJ |
| description | Orthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital assessment using computer-aided design (CAD) and computer-aided manufacturing (CAM) tools enhances surgical predictability. However, limitations in soft tissue simulation often require surgeon input to optimize aesthetic results and minimize surgical impact. This study aimed to evaluate the accuracy of virtual surgery planning (VSP) by analyzing the relationship between planning deviations and surgical satisfaction. A single-center, retrospective study was conducted on 16 patients who underwent OS at San Pedro University Hospital of La Rioja. VSP was based on CT scans using Dolphin Imaging software (v12.0, Patterson Dental, St. Paul, MN, USA) and surgeries were guided by VSP-designed occlusal splints. Outcomes were assessed using the Orthognathic Quality of Life (OQOL) questionnaire and deviations were measured through pre- and postoperative imaging. The results showed high satisfaction scores and good overall outcomes, despite moderate deviations from the virtual plan in many cases, particularly among Class II patients. A total of 63% of patients required VSP modifications due to poor soft tissue fitting, with 72% of these being Class II DFDs. Most deviations involved less maxillary advancement than planned, while maintaining optimal occlusion. This suggests that VSP may overestimate advancement needs, especially in Class II cases. No significant differences in satisfaction were observed between patients with low (<2 mm) and high (>2 mm) deviations. These findings support the use of VSP as a valuable planning tool for OS. However, surgeon experience remains essential, especially in managing soft tissue behavior. Improvements in soft tissue prediction are needed to enhance accuracy, particularly for Class II DFDs. |
| format | Article |
| id | doaj-art-3210d96cfbf1419c8c2dca28d2ca11ef |
| institution | Kabale University |
| issn | 2076-3417 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | MDPI AG |
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| series | Applied Sciences |
| spelling | doaj-art-3210d96cfbf1419c8c2dca28d2ca11ef2025-08-20T03:36:02ZengMDPI AGApplied Sciences2076-34172025-07-011515847810.3390/app15158478Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic SurgeryÁlvaro Pérez-Sala0Pablo Montes Fernández-Micheltorena1Miriam Bobadilla2Ricardo Fernández-Valadés Gámez3Javier Martínez Goñi4Ángela Villanueva5Iñigo Calvo Archanco6José Luis Del Castillo Pardo de Vera7José Luis Cebrián Carretero8Carlos Navarro Cuéllar9Ignacio Navarro Cuellar10Gema Arenas11Ana López López12Ignacio M. Larrayoz13Rafael Peláez14Bioengineering and 3D Printing Lab, Biomarkers and Molecular Signaling, Centre for Biomedical Research of La Rioja, C/Piqueras 98, 26006 Logroño, SpainOral and Maxillofacial Surgery Department, University Hospital San Pedro, C/Piqueras 98, 26006 Logroño, SpainBiomarkers, Artificial Intelligence and Signaling (BIAS), Department of Nursing, University of La Rioja, Duquesa de la Victoria 88, 26006 Logroño, SpainOral and Maxillofacial Surgery Department, University Hospital San Pedro, C/Piqueras 98, 26006 Logroño, SpainBioengineering Department, Geruza 3D Digital Solutions in Medicine, Plaza Juana García Orcoyen, 5, 31012 Pamplona, SpainBiomarkers, Artificial Intelligence and Signaling (BIAS), Department of Nursing, University of La Rioja, Duquesa de la Victoria 88, 26006 Logroño, SpainOral and Maxillofacial Surgery Department, University Hospital San Pedro, C/Piqueras 98, 26006 Logroño, SpainOral and Maxillofacial Surgery Department, University Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, SpainOral and Maxillofacial Surgery Department, University Hospital La Paz, Paseo de la Castellana, 261, 28046 Madrid, SpainOral and Maxillofacial Surgery Department, University Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, SpainOral and Maxillofacial Surgery Department, University Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, SpainOral and Maxillofacial Surgery Department, University Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, SpainOral and Maxillofacial Surgery Department, University Hospital Gregorio Marañón, C/Dr. Esquerdo 46, 28007 Madrid, SpainBiomarkers, Artificial Intelligence and Signaling (BIAS), Department of Nursing, University of La Rioja, Duquesa de la Victoria 88, 26006 Logroño, SpainBioengineering and 3D Printing Lab, Biomarkers and Molecular Signaling, Centre for Biomedical Research of La Rioja, C/Piqueras 98, 26006 Logroño, SpainOrthognathic surgery (OS) is a complex procedure commonly used to treat dentofacial deformities (DFDs). These conditions, related to jaw position or size and often involving malocclusion, affect approximately 15% of the population. Due to the complexity of OS, accurate planning is essential. Digital assessment using computer-aided design (CAD) and computer-aided manufacturing (CAM) tools enhances surgical predictability. However, limitations in soft tissue simulation often require surgeon input to optimize aesthetic results and minimize surgical impact. This study aimed to evaluate the accuracy of virtual surgery planning (VSP) by analyzing the relationship between planning deviations and surgical satisfaction. A single-center, retrospective study was conducted on 16 patients who underwent OS at San Pedro University Hospital of La Rioja. VSP was based on CT scans using Dolphin Imaging software (v12.0, Patterson Dental, St. Paul, MN, USA) and surgeries were guided by VSP-designed occlusal splints. Outcomes were assessed using the Orthognathic Quality of Life (OQOL) questionnaire and deviations were measured through pre- and postoperative imaging. The results showed high satisfaction scores and good overall outcomes, despite moderate deviations from the virtual plan in many cases, particularly among Class II patients. A total of 63% of patients required VSP modifications due to poor soft tissue fitting, with 72% of these being Class II DFDs. Most deviations involved less maxillary advancement than planned, while maintaining optimal occlusion. This suggests that VSP may overestimate advancement needs, especially in Class II cases. No significant differences in satisfaction were observed between patients with low (<2 mm) and high (>2 mm) deviations. These findings support the use of VSP as a valuable planning tool for OS. However, surgeon experience remains essential, especially in managing soft tissue behavior. Improvements in soft tissue prediction are needed to enhance accuracy, particularly for Class II DFDs.https://www.mdpi.com/2076-3417/15/15/8478computer-aided designcomputer-assisted manufacturingcomputer-aided surgeryorthognathic surgerydentofacial deformitiesmaxillofacial surgery |
| spellingShingle | Álvaro Pérez-Sala Pablo Montes Fernández-Micheltorena Miriam Bobadilla Ricardo Fernández-Valadés Gámez Javier Martínez Goñi Ángela Villanueva Iñigo Calvo Archanco José Luis Del Castillo Pardo de Vera José Luis Cebrián Carretero Carlos Navarro Cuéllar Ignacio Navarro Cuellar Gema Arenas Ana López López Ignacio M. Larrayoz Rafael Peláez Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery Applied Sciences computer-aided design computer-assisted manufacturing computer-aided surgery orthognathic surgery dentofacial deformities maxillofacial surgery |
| title | Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery |
| title_full | Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery |
| title_fullStr | Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery |
| title_full_unstemmed | Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery |
| title_short | Evaluation of Deviations Produced by Soft Tissue Fitting in Virtually Planned Orthognathic Surgery |
| title_sort | evaluation of deviations produced by soft tissue fitting in virtually planned orthognathic surgery |
| topic | computer-aided design computer-assisted manufacturing computer-aided surgery orthognathic surgery dentofacial deformities maxillofacial surgery |
| url | https://www.mdpi.com/2076-3417/15/15/8478 |
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