Abstract：
This retrospective study aimed to compare the accuracy of patient-specific implants (PSI) versus mandible-first computer-aided design and manufacturing (CAD/CAM) splints for maxilla repositioning in orthognathic surgery of skeletal Class II malocclusion patients. The main predictor was the surgical method (PSI vs. splints), with the primary outcome being the discrepancy in maxilla centroid position, and secondary outcomes being translation and orientation discrepancies. A total of 82 patients were enrolled (70 female, 12 male; mean age 25.5 years), 41 in each group. The PSI group exhibited a median maxillary position discrepancy of 1.25 mm (interquartile range (IQR) 1.03 mm), significantly lower than the splint group\'s 1.98 mm (IQR 1.64 mm) (P < 0.001). In the PSI group, the largest median translation discrepancy was 0.74 mm (IQR 1.17 mm) in the anteroposterior direction, while the largest orientation discrepancy was 1.83° (IQR 1.63°) in pitch. In the splint group, the largest median translation discrepancy was 1.14 mm (IQR 1.37 mm) in the anteroposterior direction, while the largest orientation discrepancy was 3.03° (IQR 2.11°) in pitch. In conclusion, among patients with skeletal Class II malocclusion, the application of PSI in orthognathic surgery yielded increased precision in maxillary positioning compared to mandible-first CAD/CAM splints.
摘要：
这项回顾性研究旨在比较患者特定植入物（PSI）与下颌骨第一计算机辅助设计和制造（CAD/CAM）夹板在II类骨骼错牙合患者正颌手术中上颌骨重新定位的准确性。主要预测因素是手术方法(PSIvs.夹板),主要结果是上颌骨质心位置的差异，次要结果是翻译和取向差异。共纳入82例患者（70例女性，12名男性；平均年龄25.5岁），每组41人。PSI组的上颌位置中位数差异为1.25mm（四分位距（IQR）1.03mm），显著低于夹板组的1.98mm(IQR1.64mm)(P<0.001)。在PSI组中，前后方向的最大平移差异中位数为0.74mm（IQR1.17mm），而最大的方向差异为螺距1.83°（IQR1.63°）。在夹板组中，前后方向的最大平移差异为1.14mm（IQR1.37mm），而最大的方向差异为间距3.03°（IQR2.11°）。总之,在骨骼II类错牙合的患者中，与下颌骨第一CAD/CAM夹板相比，PSI在正颌手术中的应用提高了上颌定位的精度。
