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Orthognathic Surgical Planning on Three-Dimensional Stereolithographic Biomodel

Erkan, Mustafa DDS*; Ulkur, Ersin MD; Karagoz, Huseyin MD; Karacay, Seniz MD*; Basaran, Guvenc MD*; Sonmez, Guner MD§

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1336-1341
doi: 10.1097/SCS.0b013e31821c930b
Clinical Studies

The aim of this report was to present the orthognathic surgical planning of a patient with maxillary retrusion, mandibular prognathism, and midline shift on a three-dimensional stereolithographic biomodel.

A patient who complained about facial deformity and difficulty in chewing was referred to our department. After a short-term presurgical orthodontic treatment, Le Fort I osteotomy and bilateral sagittal split ramus osteotomy were performed. Triangular axial gaps occurred anteriorly and posteriorly between the proximal and distal segments of the osteotomized mandible. These gaps were filled with bone grafts in accordance with templates that were constructed on a three-dimensional stereolithographic biomodel.

Rotational movement of the distal mandibular segment around the y axis caused axial triangular gapping between the proximal and distal mandibular segments. In the presented case, orthognathic surgical planning was performed on the three-dimensional solid models, and templates were reconstructed according to these gaps. These templates were used to determine the size of the bone grafts during the surgical approach. The patient was diagnosed with lateral cephalometric and posteroanterior cephalometric analysis in postretention for 2 years, and it was determined that long-term results were perfect and skeletal relapse did not occur after 2.5 years of surgery.

Movement at the site of the osteotomy is usually the main cause of relapse after orthognathic surgery. In the presented case, a three-dimensional stereolithographic biomodel was used to plan the orthognathic surgery and to reconstruct the templates to determine the size and shape of the bone grafts. Using bone grafts established close contact between proximal and distal osteotomized bone segments, enhanced bone healing, and diminished relapse risk.

From the Departments of *Orthodontics and †Plastic and Reconstructive Surgery, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul; ‡Department of Plastic and Reconstructive Surgery, Maresal Cakmak Military Hospital, Erzurum; and §Department of Radiology, Gulhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.

Received June 16, 2010.

Accepted for publication September 14, 2010.

Address correspondence and reprint requests to Huseyin Karagoz, MD, Plastik Cerrahi Servisi, Maresal Cakmak Asker Hastanesi, 25070 Erzurum, Turkey; E-mail:

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD