Validation of mandibular genioplasty using a stereolithographic surgical guide: in vitro comparison with a manual measurement method based on preoperative surgical simulation.
OBJECTIVE
Stereolithographic guidance, increasingly used in orthognathic surgery, has not been completely verified for genioplasty. This study compared the accuracy of manual measurement with that of a stereolithographic guide in vitro.


METHODS
Thirty rapid prototype (RP) mandibular models (15 pairs) were included in the experimental (stereolithographic) and control (manual) groups (15 each). Surgical simulation was performed in the 2 groups by advancing the chin 5 mm and then vertically reducing the chin 5 mm using Mimics software. In the stereolithographic group, genioplasty was performed on mandibular RP models using a 3-dimensionally printed surgical guide based on surgical simulation results. In the control group, it was performed using an osteotomy line drawn according to simulation measurements. For the 2 groups, anterior horizontal transverse error and anterior and posterior vertical errors were compared, as were data from the osteotomized chin segment and the preoperative surgical simulation. Positional difference error was calculated and the differences were evaluated with t tests.


RESULTS
For advancement genioplasty, the absolute anterior transverse error value was 0.47 ± 0.35 (mean ± standard deviation) with the stereolithographic guide, less than with the manual method (0.77 ± 0.45; P = .001). For reduction genioplasty, the absolute anterior vertical error value was 0.27 ± 0.23 mm with the stereolithographic guide versus 0.58 ± 0.49 mm with the manual method (P < .001).


CONCLUSIONS
Use of a stereolithographic surgical guide increased accuracy, but the difference in mean error values between methods was only approximately 0.3 mm. The superior accuracy may not be compelling in favor of stereolithographic surgical guides.
Faculty, Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang; Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Republic of Korea. Electronic address: omfs1ksh@daum.net.
Sang-Hoon
SH
Kang
Chief Resident, Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Jae-Won
JW
Lee
Resident, Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Se-Ho
SH
Lim
Resident, Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Republic of Korea.
Yeon-Ho
YH
Kim
Faculty, Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang; Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, Yonsei University, Seoul, Republic of Korea.
Moon-Key
MK
Kim
D002508:Cephalometry / Q000379:methods; D002680:Chin / Q000033:anatomy & histology / Q000601:surgery; D003198:Computer Simulation; D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography / Q000379:methods; D063172:Genioplasty / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D008334:Mandible / Q000033:anatomy & histology / Q000601:surgery; D063168:Mandibular Osteotomy / Q000295:instrumentation; D008953:Models, Anatomic; D010347:Patient Care Planning; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods; D014584:User-Computer Interface