Long-Term Stability of the Use of Patient Specific Implants in Orthognathic Surgery: A Systematic Review

TL;DR

This review shows that patient-specific implants in jaw surgery are stable and reliable over the long term, with low complication rates.

Contribution

The study provides a systematic evaluation of the long-term stability of patient-specific implants in orthognathic surgery.

Findings

PSIs showed minimal movement (0.27-1.07 mm) and angular changes (0.1°-0.5°) over time.

Operation time using PSIs was 15.7% shorter than with conventional methods.

Complications and reoperation rates were reported as 0 in some studies.

Abstract

This systematic review aimed to evaluate the long-term stability of patient-specific implants (PSIs) in orthognathic surgery.

The review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search including an electronic search of numerous databases with keywords, manual and reference searches was performed. The search results were evaluated and underwent 2 rounds of elimination, first by title and abstract and second by fulfilling the 6 predetermined criteria. The included studies underwent the final systematic review.

Six studies with a total of 171 subjects were included in the final review. The long-term stability of the use of PSIs in orthognathic surgery ranged from 0.27 mm to 0.5 mm for the x-axis and 0.3 mm to 1.07 mm for the y-axis. The mean change was 0.1°, 0.5° and 0.2° for the pitch, roll and yaw, respectively. The absolute mean difference of the SNA angle was 0.57°. The mean duration of operation for using PSIs was shorter than the use of conventional miniplates in orthognathic surgery by 15.7%. Complications and reoperation rates when using PSIs in orthognathic surgery were reported to be 0 in 3 studies and not reported in the other 3 studies.

The results of this systematic review indicate that PSIs demonstrate clinically acceptable stability over the medium-to-long term and represent a reliable method of fixation in orthognathic surgery. Additional high-quality studies with standardised methodology and longer follow-up period of more than 24 months are recommended.

This systematic review highlights the high level of long-term stability when using PSIs in orthognathic surgery in terms of bodily movements, complications and reoperation rates. Oral and maxillofacial surgeons and biomechanical engineers may now have a more comprehensive and deeper understanding of the use of PSIs in the long term, which can assist them in choosing the method of fixation in orthognathic surgery.

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