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Individualized Surgical Templates and Titanium Microplates for Le Fort I Osteotomy by Computer-Aided Design and Computer-Aided Manufacturing

He, Wei PhD*; Tian, Kaiyue MD*; Xie, Xiaoyan MD; Wang, Xiaoxia MD*; Li, Yang MD*; Wang, Xing MD*; Li, Zili MD*

doi: 10.1097/SCS.0000000000001938
Original Articles

The authors report the use of novel individualized surgical templates and titanium miniplates for Le Fort I osteotomy and evaluate the accuracy of this technique in vitro. Nine three-dimensional stereolithographic skull models were used to design the templates and titanium microplates and to simulate the operation. Cone beam computed tomography (CBCT) scans of the skulls were acquired preoperatively and were used to generate virtual models. The surgical plans were made based on three-dimensional cephalometric analyses, and osteotomies were then performed virtually. Cylinder-shaped markers were placed to permit the correct location of titanium screws, and individualized surgical templates were designed. The bony segments were then repositioned virtually according to the surgical plans to correct the skeletal deformities. Resin surgical templates were produced by stereolithography rapid prototyping and the titanium miniplates by three-dimensional cutting. Le Fort I osteotomy was performed under the guide of the surgical templates and fixed with the titanium miniplates. Postoperatively, CBCT scans of each skull model were taken, and the differences between the actual and planned surgical outcomes were measured by superimposing the planned and postoperative virtual models generated from CBCT images. The authors demonstrated that the average linear difference between the planned and actual outcomes was <1 mm and the average orientation difference was <1°. The individualized surgical templates and titanium microplates designed in this experimental study permitted the repositioning of the maxillary segment to the correct planned positions during Le Fort I osteotomy, making this technique a promising alternative to the conventional split method.

*Department of Oral and Maxillofacial Surgery

Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China

Address correspondence and reprint requests to Dr Li Zili, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 Zhongguancun Nandajie St, Haidian District, Beijing 100081, China; E-mail:

Received 5 September, 2014

Accepted 27 April, 2015

This study was supported by the new technique and new treatment modality fund of Peking University School and Hospital of Stomatology and by the National Natural Science Foundation of China (81250006).

The authors report no conflicts of interest.

© 2015 by Mutaz B. Habal, MD.