title: Splintless orthognathic surgery: a novel technique using patient-specific implants (PSI).
abstract: In the past few years, advances in three-dimensional imaging have conducted to breakthrough in the diagnosis, treatment planning and result assessment in orthognathic surgery. Hereby error-prone and time-consuming planning steps, like model surgery and transfer of the face bow, can be eluded. Numerous positioning devices, in order to transfer the three-dimensional treatment plan to the intraoperative site, have been described. Nevertheless the use of positioning devices and intraoperative splints are failure-prone and time-consuming steps, which have to be performed during the operation and during general anesthesia of the patient. We describe a novel time-sparing and failsafe technique using patient-specific implants (PSI) as positioning guides and concurrently as rigid fixation of the maxilla in the planned position. This technique avoids elaborate positioning and removal of manufactured positioning devices and allows maxillary positioning without the use of occlusal splints.
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Zürich, Zürich, Switzerland. Electronic address: Thomas.Gander@usz.ch.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gander
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Marius
authors.initials: M
authors.lastname: Bredell
authors.affiliation: Department of Orthodontics and Paedodontics, Center of Dental Medicine, Zürich, Switzerland.
authors.forename: Theodore
authors.initials: T
authors.lastname: Eliades
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Rücker
authors.affiliation: Department of Oral and Maxillofacial Surgery, University Hospital of Zürich, Zürich, Switzerland.
authors.forename: Harald
authors.initials: H
authors.lastname: Essig
mesh_terms: D000293:Adolescent; D000539:Alveolar Process / Q000601:surgery; D000848:Anodontia / Q000628:therapy; D017076:Computer-Aided Design; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D016268:Internal Fixators; D008437:Maxilla / Q000002:abnormalities / Q000601:surgery; D008844:Micrognathism / Q000601:surgery; D009296:Nasal Cavity / Q000601:surgery; D056948:Orthognathic Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D019340:Osteotomy, Le Fort / Q000295:instrumentation / Q000379:methods; D010347:Patient Care Planning; D066230:Patient-Specific Modeling; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D014584:User-Computer Interface; D015050:Zygoma / Q000601:surgery
keywords: Computer-aided design (CAD); Computer-aided manufacturing (CAM); Orthognathic surgery; Patient-specific implants (PSI)