Abstract
The aim of this systematic review is to evaluate the accuracy of waferless osteotomy
procedures in orthognathic surgery with a secondary aim to determine the cost-effectiveness
of the procedure. A literature search was conducted on the databases PubMed and Scopus,
with PRISMA guidelines followed. An initial yield of 4149 articles were identified,
ten of which met the desired inclusion criteria. The total sample of patients undergoing
waferless osteotomies included in this review was 142 patients. Nine of the studies
used surgical cutting guides along with customised surgical plates to eliminate the
surgical wafer and one study used pre-bent locking plates instead of customised plates.
The eligible articles determined their surgical accuracy by comparing the positions
of bony or dental landmarks on the pre-operative and post-operative images. The articles
all reported acceptable accuracy within previously established clinical parameters.
The majority of authors concluded that it is an accurate surgical approach and can
be cost effective which is often a barrier to novel techniques however there were
studies that contrasted the view of the cost efficacy. Due to the lack of published
randomised controlled trials, current evidence is not strong enough to recommend the
use of surgical cutting guides and customised/pre-bent plates for orthognathic surgery.
Keywords
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Article Info
Publication History
Published online: May 08, 2021
Accepted:
May 3,
2021
Identification
Copyright
Crown Copyright © 2021 Published by Elsevier Ltd on behalf of The British Association of Oral and Maxillofacial Surgeons. All rights reserved.
