ACCURACY OF ORTHOGNATHIC SURGERY USING THREEDIMENSIONAL DIGITAL PLANNING IN PATIENTS WITH TRANSVERSE MAXILLARY DEFICIENCY
DOI:
https://doi.org/10.35220/2523-420X/2023.4.16Keywords:
orthognathic surgery, three-dimensional digital planning, transverse maxillary deficiency, malocclusionAbstract
Introduction. The article is devoted to the improvement of orthognathic surgery techniques through the use of three-dimensional digital planning in order to increase the accuracy of surgical interventions for the correction of transverse maxillary deficiency. The aim of the study is to analyze the accuracy of orthognathic surgery using threedimensional digital planning in patients with TMD requiring surgically assisted palatal expansion (SARME) at the stage of preoperative orthodontic preparation. Materials and methods. The study used a sample of 50 patients with skeletal forms of jaw anomalies and deformities who were treated from 2019 to 2023. 50 patients with TMJ TD and sagittal/vertical malocclusion were divided into 2 groups: the main group (n=25): SARME with the use of Smile distractor (Titamed, Belgium) at the stage of preoperative orthodontic preparation and the control group (n=25): No or previously corrected TMJ TD. In both groups, orthognathic operations were performed according to a full digital protocol using 3D computed tomography (CT) data and virtual planning. The use of three-dimensional planning allowed us to optimize preoperative preparation and determine the optimal parameters of surgery. The results of the study demonstrated a significant increase in the accuracy of orthognathic operations, a reduction in the risk of recurrence and side effects with minor deviations from the planned indicators. The authors conducted a detailed analysis of the effectiveness of digital planning to ensure the accuracy of orthognathic surgery in patients with various forms of skeletal anomalies of the jaws. The scientific novelty lies in the confirmation of the effectiveness of SARME as a technique that allows to optimize preoperative preparation and improve the accuracy of orthognathic surgery in patients with transverse maxillary deficiency (TMD). It has been established that the use of the Smile distractor (Titamed, Belgium) for TMJ expansion allows to achieve a high level of accuracy of predictability of the result, which is a significant achievement in improving the quality of life of patients. The conclusions confirm the high efficiency of digital technologies in orthognathic surgery for patients with TD of the TMJ, which allows for better accuracy and predictability of treatment results, minimizing the risk of complications. Limitations of the study included the heterogeneity of the initial conditions of patients in terms of skeletal class, growth type, and the presence of an open or deep bite, which may affect the versatility and accuracy of the results.
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