Accuracy of Computer-Assisted Design and Manufactured (Cad/Cam) Three-Dimensional (3d) Device for Condylar Positioning in Mandibular Bilateral Sagittal Split Osteotomy (Clinical Trial)

Introduction: All techniques for orthognathic surgery after Le Fort I osteotomy or bilateral sagittal split osteotomy rely on intermediate and final occlusal splints for proper positioning of the dental arches without any control in the position of the condyle and ramus segments. Aim of the study: To clinically and radiographically assess the accuracy of CAD/CAM surgical guide for condylar positioning in the bilateral sagittal split osteotomy. Materials and Methods: Eight patients with non-syndromic dentofacial deformity requiring BSSO with or without maxillary osteotomy treated with orthognathic surgery were enrolled in this study. The surgery was planned according to (CAD/CAM) technology. After osteotomy, a preoperative guide was used, followed by a repositioning guide. Computed tomography scans were performed in all patients one week preoperatively, immediately, and three months postoperatively to assess the condylar position and facial symmetry. Results: Data are presented as median [25th–75th percentile]. Eight patients (37.50% females and 62.50% males), with ages ranged from (19 to 24 years) underwent bilateral sagittal split osteotomy with or without LeFort I maxillary advancement. The surgical outcome revealed the satisfactory correction of their skeletal deformity. The absolute change between immediate postoperative and preoperative Condylar Angle was 0.15 [0.00-0.3]°. The absolute change between three months postoperative and preoperative Condylar Angle was 0.20 [0.00-0.30]°. Conclusion: The stability of the condylar head in position and patient postoperative occlusion is well assessed by 3D condylar positioning devices designed and manufactured by CAD/CAM technology in the mandibular bilateral sagittal split osteotomy.