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Published in: Oral and Maxillofacial Surgery 1/2024

24-10-2022 | Original Article

On the use of intraoperative 3D-RX C-arm imaging in orthognathic surgery: a prospective non-consecutive case series study

Authors: Nikolas K. G. De Meurechy, Christopher Decoste, Maurice Y. Mommaerts

Published in: Oral and Maxillofacial Surgery | Issue 1/2024

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Abstract

Context

Segment and osteosynthesis malposition resulting in patients’ complaints (mainly about asymmetries) are encountered in orthofacial/orthognathic surgery.

Objective, design, and setting

We planned to investigate the usefulness of intraoperative three-dimensional (3D) imaging concerning positioning and fixation of bone segments and osteosynthesis in orthognathic/orthofacial surgery. We performed a prospective study of non-consecutive cases. All patients receiving a bimaxillary osteotomy, genioplasty, and their combinations were included in the study from May 2016 to May 2020. Unilateral and bilateral sagittal split osteotomies were excluded. There were no gender and age limitations. All were intraoperatively examined using the BV Pulsera 3D-RX System (Philips Medical, Eindhoven, The Netherlands). The outcome variables were the percentage of revisions of segment positioning and osteosynthesis. Predictor variables were age, gender, type of surgery, timing (pre- and post-imaging), and surgeon experience (senior vs assistant).

Results

Forty female and twenty-two male patients were included (mean age 25.25 years ± 7.52 and 29.1 years ± 12.6 respectively). We evaluated 27 genioplasties and 34 Le Fort “type-I” osteotomies. Indications for segment repositioning and redo-osteosynthesis increased after intraoperative imaging as compared to operator’s clinical judgment before intraoperative imaging (95% confidence interval; p < .001 and p = .002 respectively).

Conclusion

Suboptimal positioning and fixation of bone segments or osteosynthesis were more apparent with 3D imaging. In addition, some satisfactory cases were also revised for an optimal outcome. As a result, surgeons were prompted to more revisions than judged necessary without intraoperative imaging.
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Metadata
Title
On the use of intraoperative 3D-RX C-arm imaging in orthognathic surgery: a prospective non-consecutive case series study
Authors
Nikolas K. G. De Meurechy
Christopher Decoste
Maurice Y. Mommaerts
Publication date
24-10-2022
Publisher
Springer Berlin Heidelberg
Published in
Oral and Maxillofacial Surgery / Issue 1/2024
Print ISSN: 1865-1550
Electronic ISSN: 1865-1569
DOI
https://doi.org/10.1007/s10006-022-01119-1

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