3D Printed Custom Made Cutting Guides and Plates for Maxillary Repositioning in Orthognathic Surgery: An Evaluation of the Accuracy of the Results.

Abstract

This study evaluates the accuracy of 3D preoperative planning and 3D printed custom cutting guides and plates for maxillary repositioning in orthognathic surgery. A retrospective analysis was conducted on 28 patients treated at our institute between January 2022 and December 2024. All underwent orthognathic surgery with custom cutting guides and plates for the maxilla and bilateral sagittal split osteotomy (BSSO) for the mandible. Inclusion criteria included skeletal class II or III malocclusion, completion of presurgical orthodontics, and 3D planning using ProPlan software. Each patient underwent 3D photography and CBCT at multiple time points, including pre- and postsurgery (6 months). The positions of the A point, the anterior nasal spine (ANS), the posterior nasal spine (PNS), the incisor mid, the right and the left canine, and the right and the left first molar were marked on the 3D program and the post-op CBCT, and the discrepancies were analyzed. For each cephalometric point considered the mean and the SD of the discrepancy values were calculated. The values were also analyzed according to a linear regression model and a t test was conducted. The study confirms high accuracy in maxillary repositioning when using computer-aided planning with customized guides and plates, showing these tools can improve accuracy, efficiency, and outcome prediction.