Planejamento assistido por computador em cirurgia ortognática : revisão sistemática

Abstract

The objectives of this study is to conduct a systematic review to evaluate the accuracy of computer-aided design and computer-aided manufacturing planning in orthognathic surgery, to determine the quality of the current literature and the need for new methods on this subject . A systematic literature search was performed in PubMed, EMBASE, Cochrane Library, LILACS and SciELO. The gray literature was investigated in Google Scholar and in the annals of the most important conferences of Oral and Maxillofacial Surgery. The papers found passed for a selection criteria and eligibility by two authors independently and blindly. After the selection of eligible studies, it was made a manual search in the references of the included papers and then data extraction and analysis of quality were performed. By searching in the databases 350 studies were found. So, 33 were selected for full reading and six were included in the study. Through the gray literature search, four papers were selected for full reading and only one was included. From the manual search one study was included. Thus, eight studies were included in this systematic review. The level of agreement among the authors for studies selection was substancial (kappa= 0.767) and studies eligibility was considered excellent (kappa= 0.863). The accuracy in computer-aided design and computer-aided manufacturing planning in orthognathic surgery in the translation were less than 1.2 mm in the maxilla (vertical) and less than 1.1 mm in the mandible (sagittal), and in the rotations were less than 1.5° in the maxilla (pitch) and less than 1.8° in the mandible (pitch). Two studies showed a medium potential for risk of bias and six studies showed a high potential for risk of bias. The computer-aided design and computer-aided manufacturing planning in orthognathic surgery is considered accurate to the studies included in this systematic review. However, the low quality of the studies makes that the development of randomized clinical trials are needed to assess whether it really brings major benefits to the patient and to the surgical procedure compared to conventional planning