Accuracy of Maxillary Repositioning Using Customized Maxillary Bone-Dental-Supported Guides

The purpose of this study was to compare the accuracy of maxillary repositioning using customized maxillary bone-dental-supported guides with that using an intermediate computer-aided design and computer-aided manufacturing (CAD/CAM) splint. This retrospective cohort study included patients with dentofacial deformities on computed tomography before and 3 months after surgery. Differences between the planned and actual postoperative positions of the maxilla were measured using simulation software for 3 landmarks. Twenty-two patients were treated using customized maxillary bone-dental-supported guides (group A) and 22 patients were treated using intermediate CAD/CAM splints (group B). For all 3 axes, discrepancies for all 3 landmarks tended to be smaller in group A than in group B. In particular, intermediate splints, calculated over the 22 cases and all 3 landmarks, showed significantly larger discrepancies on all 3 axes than the customized maxillary bone-dental-supported guides, calculated over the 22 cases and all 3 landmarks. In conclusion, customized maxillary bone-dental-supported guides appear more effective than intermediate CAD/CAM splints in achieving accurate transfer from 3D simulation to real surgery.