The 3D maxillary orientation device (3DMOD) - a novel device for measuring post-surgical three-dimensional maxillary changes

Rahman, Zarish (2023). The 3D maxillary orientation device (3DMOD) - a novel device for measuring post-surgical three-dimensional maxillary changes. University of Birmingham. M.Sc.

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Abstract

Objectives: To assess the validity and reproducibility of the 3D Maxillary Orientation Device to assess the simulated post-surgical 3D changes of the maxilla using an in vivo model.
Methodology: A 3D maxillary orientation device (3DMOD) was developed based on a modified Fox’s occlusal plane guide. Equidistant points were marked on the extra-oral arms of the 3DMOD creating nine landmarks for data analysis. Reproducibility of 3DMOD insertion and removal was assessed by placing the 3DMOD onto the maxillary dentition of five volunteers and taking extra-oral facial 3D stereophotogrammetry images (Di4D SNAP system) at one-week intervals (T1 and T2). To measure the post-surgical changes of the maxilla, the 3DMOD was secured to the maxillary dentition of an in vivo skull model. The position of the 3DMOD changed a known amount using modified Lego® blocks attached to the 3DMOD, to simulate various maxillary movements. Baseline images of the 3DMOD were taken with 0mm displacement and again with the 3DMOD advanced and vertically impacted by 3mm, 6mm and 9mm. Additionally a left and right cant and 3mm advancement with posterior differential impaction were simulated. Images were re-taken one-week later (T1 and T2). Following baseline and simulated maxillary movement, the changes of the landmarks in the x, y and z direction were determined using Di3D viewing software for data analysis.
Results: For 3DMOD insertion on replacement the mean differences in the x, y and z direction were all significantly less than 0.5mm. The difference between the simulated maxillary movements (advancement and impaction) and the 3DMOD derived measurements were all statistically significantly 0.5mm or less. The device was reproducible, none of the mean differences between T1 and T2 were significantly greater than 0.5mm (95% CI range 0.0mm and 1.1mm).
Conclusion: The 3DMOD, coupled with stereophotogrammetry, is an acceptable method to measure 3D simulated maxillary movements. Further studies are needed to assess the validity and reproducibly of using the 3DMOD in patients undergoing maxillary osteotomies.

Type of Work:

Thesis (Masters by Research > M.Sc.)

Award Type:

Masters by Research > M.Sc.

Supervisor(s):