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Research Article| Volume 58, ISSUE 9, P1116-1122, November 2020

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Improvement in accuracy of maxillary repositioning of Le Fort I osteotomy with Orthopilot™ Navigation System: evaluation of 30 patients

  • R. Lartizien
    Correspondence
    Corresponding author at: Maxillofacial Surgery Department, Annecy Genevois Hospital, 1 avenue de l’hôpital, 74370 Epagny Metz-Tessy, France.
    Affiliations
    Maxillofacial Surgery Department, Annecy Genevois Hospital, 1 avenue de l’hôpital, 74370 Epagny Metz-Tessy, France

    Université Grenoble Alpes, Medicine Faculty, 23 Avenue Maquis du Grésivaudan, 38700 La Tronche, France
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  • I. Zaccaria
    Affiliations
    Clinical Research Department, Annecy Genevois Hospital, 1 avenue de l’hôpital, 74370 Epagny Metz-Tessy, France
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  • L. Noyelles
    Affiliations
    Maxillofacial Surgery Department, Annecy Genevois Hospital, 1 avenue de l’hôpital, 74370 Epagny Metz-Tessy, France
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  • G. Bettega
    Affiliations
    Maxillofacial Surgery Department, Annecy Genevois Hospital, 1 avenue de l’hôpital, 74370 Epagny Metz-Tessy, France
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      Abstract

      Traditional model surgery with facebow transfer is not very accurate. We aimed to demonstrate that the Orthopilot™ Navigation System improves the accuracy of maxillary repositioning during Le Fort I osteotomy. Thirty patients underwent Le Fort I osteotomy alone or associated to sagittal split osteotomy. The maxilla positioning was done in two phases. First, the maxilla was positioned with the traditional occlusal splint, the position (“without Orthopilot™”) was recorded by the Orthopilot™. In the second phase, the Orthopilot™ was used to improve positioning; and the final position (“with Orthopilot™”) was recorded, after osteosynthesis. Positioning data were compared with planned data. Positioning data with and without the Orthopilot™ were also compared. Accuracy was classified in distinct classes with three major criteria (conformity, non-conformity, failure) according to the discrepancies. Conformity rate was significantly greater with the Orthopilot™ (2 without the Orthopilot™ compared with 8 with the Orthopilot™; p = 0.01). The failure rate was significantly lower with the Orthopilot™ (18 without Orthopilot™ compared with 7 with the Orthopilot™; p = 0.002). Dispersions of discrepancies were usually lower in all directions with the Orthopilot™. Navigation reduced the risk of discrepancy without cancelling it, especially when large movements are planned. The Orthopilot™ therefore improved the accuracy of traditional occlusal splint during Le Fort I osteotomy.

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