Daniel Buchbinder, DMD, MD
Professeur et chef de système
Division de chirurgie maxillo-faciale
Département d'oto-rhino-laryngologie, chirurgie de la tête et du cou
Système de santé Mount Sinaï
École de médecine Icahn du Mont Sinaï

For decades, model surgery was the standard method for treatment planning in orthognathic surgery. However, the introduction of computer assisted planning tools has significantly reduced its use. Today, surgeons typically combine computer-assisted planning with patient-specific plates to guide surgery. A key innovation is the use of 3D-printed patient-specific plates and cutting guides, which allow for a more precise transfer of the surgical plan to the operating room. The digital workflow begins with clinical evaluation, followed by cephalometric analysis, creation of 3D models, model surgery, CAD/CAM splint fabrication, and surgery. A newer approach eliminates the need for physical casts or splints by using optical scanners to merge CT data with optical scans, creating precise virtual models for surgery. This digital workflow enables full virtual planning, including occlusion management and the creation of 3D-printed surgical guides, which enhance the accuracy and efficiency of the procedure. The use of patient-specific plates offers several advantages: increased accuracy, efficiency, safety, and cost-effectiveness. However, it also presents challenges, such as the inability to modify the plan intraoperatively and the high cost and limited accessibility of the technology. Studies have shown that virtual planning and 3D-printed plates provide high precision in repositioning the maxilla, with sub-millimeter discrepancies between planned and postoperative results. Further research supports the accuracy and effectiveness of this method over traditional techniques. Additionally, some studies indicate significant cost savings, considering the reduction in planning time and increased surgical efficiency. This presentation will explore the evolution of computer-assisted planning and patient specific implants in orthognathic surgery, offering a glimpse into what the future may hold.