Validation of the OrthoGnathicAnalyser 2.0—3D accuracy assessment tool for bimaxillary surgery and genioplasty

Orthognathic surgery is a widely performed procedure to correct dentofacial deformities. Virtual treatment planning is an important preparation step. One advantage of the use of virtual treatment planning is the possibility to assess the accuracy of orthognathic surgery. In this study, a tool (OrthoGnathicAnalyser 2.0), which allows for quantification of the accuracy of orthognathic surgery, is presented and validated. In the OrthoGnathicAnalyser 2.0 the accuracy of the osseous chin can now be assessed which was not possible in the earlier version of the OrthoGnathicAnalyser. 30 patients who underwent bimaxillary surgery in combination with a genioplasty were selected from three different centers in the Netherlands. A pre-operative (CB)CT scan, virtual treatment planning and postoperative (CB)CT scan were required for assessing the accuracy of bimaxillary surgery. The preoperative and postoperative (CB)CT scans were aligned using voxel-based matching. Furthermore, voxel-based matching was used to align the pre-operative maxilla, mandible and rami towards their postoperative position whereas surface-based matching was used for aligning the pre-operative chin towards the postoperative position. The alignment resulted in a transformation matrix which contained the achieved translations and rotations. The achieved translations and rotations can be compared to planning values of the virtual treatment plan. To study the reproducibility, two independent observers processed all 30 patients to assess the inter-observer variability. One observer processed the patients twice to assess the intra-observer variability. Both the intra- and inter-observer variability showed high ICC values (> 0.92) and low measurement variations (< 0.673±0.684mm and < 0.654±0.824°). The results of this study show that the OrthoGnathicAnalyser 2.0 has an excellent reproducibility for quantification of skeletal movements between two (CB)CT scans.