Clinical comparison of two external anatomical references for maxillary positioning in orthognathic surgery

Mauricio Barreda Hale*, Jorge Lolas, Emilio Moreno, Daniel Pino D., Camila Arrué, Javier Beytía Erazo

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: The use of external reference points (ERP) like the nasal pin (NP) and eye’s medial canthus (EMC) provides a stable and reproductible landmarks for maxillary repositioning. ERP are widely used, for its practicality to achieve the desired aesthetic result in orthognathic surgery (OS).
Objectives: The purpose of this study is to compare the ERPs: NP and EMC, to define which is the most accurate, and also define its limitations, in the intraoperative phase for vertical repositioning of the maxilla.
Patients and methods: We performed a retrospective study on 26 patients who underwent OS from December 2015 to August 2018. Previous to the Le Fort I osteotomy, the vertical measurements were made. The most accurate ERP was considered to be the one that obtained the least average difference between the vertical measurement of the pre-surgical planning and that obtained in the intraoperative period.
Results: The planned vertical movement was an average of -1.73 mm ± 1.97 SD, with the largest maxillary impaction movement of -6 mm and the largest maxillary descent of 2 mm. The difference between planned vertical movement and obtained measurements of vertical change for NP had an average 0.05 mm ± 0.51 SD (95 % CI, -0.15 - 0.26), and the difference between planned vertical movement and obtained measurements for EMC had an average 1.23 mm ± 1.29 SD (95 % CI, 0.71 - 1.75), with a statistically significant difference (p = 0.0001) between them of -1.18 mm± 1.23 (95 % CI, -1.67 - -0.68).
Conclusions: The use of the NP as an ERP provides greater precision and predictability of movement in the vertical repositioning of the maxillomandibular-complex, compared to the use of EMC. Both techniques can be used as a complement, being aware of the effect of triangulation.
Translated title of the contributionComparación clínica de las referencias anatómicas externas para posicionamiento maxilar en cirugía ortognática
Original languageEnglish
Pages (from-to)158-164
Number of pages7
JournalRevista Espanola de Cirugia Oral y Maxilofacial
Volume42
Issue number4
DOIs
StatePublished - 2020
Externally publishedYes

Bibliographical note

© 2020 SECOM.

Keywords

  • Facial asymmetry
  • Le Fort osteotomy
  • Maxillary osteotomy
  • Medial canthus
  • Nasal pin
  • Orthognathic surgery

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