CAD/CAM surgical guides and pre-bent distractors: Enhancing precision in MDO for severe dentofacial deformities secondary to TMJ ankylosis.

Abstract

Background: This study aimed to compare the different outcomes of mandibular distraction osteogenesis (MDO) using computer-aided design and manufacturing (CAD/CAM) surgical guides accompanied by pre-bent distractors versus CAD/CAM surgical guides with commercial distractors.

Methods: Twenty-eight patients with severe dentofacial deformities secondary to unilateral temporomandibular joint ankylosis (TMJA) were retrospectively enrolled. Ten parameters associated with MDO were measured preoperatively, virtually, and postoperatively. The hard-tissue digital model was reconstructed using Mimics Research 17.0, and imaging data were collected and analyzed using Freeform Plus software 12.0, Geomagic Studio 12.0, and IBM SPSS Version 20.0.

Results: Twenty-eight patients underwent MDO with subsequent adjunctive surgery and were evaluated. Thirteen patients underwent CAD/CAM surgical guides with pre-bent distractors (group A), while fifteen underwent CAD/CAM guides with commercial distractors (group B). Both techniques achieved optimal occlusion and satisfactory appearance. Statistical analysis showed group A demonstrated a more accurate control of vector direction during MDO compared to group B (p < 0.05). Additionally, group A also exhibited a shorter subsequent treatment duration and less relapse compared to group B (p < 0.05).

Conclusions: CAD/CAM surgical guides with pre-bent distractors can significantly enhance surgical accuracy in controlling the vector direction of MDO for correcting dentofacial deformities secondary to TMJA, leading to a reduction in subsequent treatment duration and occurrence.