Technical Brief

Maxillary Cutting Guide for Executing a Simulated Osteotomy and Removing the Bony Interference During Orthognathic Surgery

[+] Author and Article Information
Sang-Hoon Kang

Department of Oral and Maxillofacial Surgery,
National Health Insurance Service Ilsan Hospital,
100 Ilsan-ro, Ilsan-donggu, Goyang,
Gyeonggi-do 410-719, South Korea
e-mail: omfs1ksh@hanmail.net

Hak-Jin Kim

Department of Oral and Maxillofacial Surgery,
Yongin Severance Hospital,
23 Yongmunno, Yongin,
Gyeonggi-do 449-930, South Korea
e-mail: kimaka1@hanmail.net

Ha-Won Park

Department of Biomedical Engineering,
Anyang, Gyeonggi-do 431-804, South Korea

Sang-Hwy Lee

Department of Oral and Maxillofacial Surgery,
College of Dentistry,
Yonsei University,
50 Yonsei-ro, Seodaemun-gu,
Seoul 120-752, South Korea
e-mail: sanghwy@yuhs.ac

1Corresponding author.

Manuscript received January 14, 2015; final manuscript received June 8, 2015; published online August 12, 2015. Assoc. Editor: Rita M. Patterson.

J. Med. Devices 9(4), 044505 (Aug 12, 2015) (3 pages) Paper No: MED-15-1005; doi: 10.1115/1.4031162 History: Received January 14, 2015

The results of surgical simulation need to be transferred to the operation table with precision and confidence. We want to introduce a three-dimensional (3D)-printed maxillary cutting guide to perform the simulation-based maxillary osteotomy, interference removal, and the device guide for maxillary orthognathic surgery. The orthognathic simulation is performed with a horizontal osteotomy line and the maxillary segmental movement on a computed tomography (CT)-based 3D model. The maxillary cutting guide is designed as a band-shaped template encompassing the osteotomy line, bone interference area, and guiding holes. The design is exported to a 3D printer and the cutting guide is printed with biocompatible resin materials. The cutting guide was applied to 45 orthognathic surgeries. It could assist the easy and accurate osteotomy as planned and eliminate the repeated empirical checks of the premature interference site while preventing excessive bone reduction. This device guides the surgeon to place the osteotomy line, predict and remove the bony interferences, and place holes for additional surgical devices for maxillary orthognathic surgery.

Copyright © 2015 by ASME
Topics: Surgery , Cutting , Simulation , Bone
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Grahic Jump Location
Fig. 1

The maxillary segment is placed according to the treatment plan in the simulation surgery

Grahic Jump Location
Fig. 2

An image of the bony interference area. For the repositioning of maxilla during orthognathic surgery, the location and area of bony interference (marked in red and indicated by the arrowhead) are calculated and extracted based on the preoperative surgical simulation.

Grahic Jump Location
Fig. 3

Computer-aided design and manufacturing (CAD/CAM)-based design of a maxillary cutting guide (in band shape) with cutting line, bone interference (arrowhead), and guide holes on the maxilla. The screw-shaped drill guide made of stainless steel (arrow) was mounted in the guide holes for accurate drilling.

Grahic Jump Location
Fig. 4

An image of a 3D-printed cutting guide placed in situ at the operation room

Grahic Jump Location
Fig. 5

A high level of accuracy is evident in comparing 3D maxillary models created from the simulated plan with immediate postoperative CT images, using superimposition and a color-coded discrepancy map



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