CATEGORY AUSTRALASIAN DENTIST 77 CLINICAL and drilling guides as well as patient specific bone plates. On the planning side, every screw hole is measured and colour coded for length and thickness (Fig. 9). Vital structures like nerves or root apices are also clearly displayed on the plan so the screws are placed well away from these sites (Fig. 9). Digital technology not only helps streamline the surgical planning, but also significantly improves the accuracy of jaw positioning in all 3 dimensions which is very difficult to achieve with hand-held intermediate splints that rely on proper seating of the condyles in their respective fossae. Furthermore, the Tri-Fix Orthognathic System also provides a simple and unique sagittal split cutting guide (Fig. 12) that allows for a more accurate medial osteotomy along the mandibular ramus that aligns the cutting tool with the lingula of the mandibular foramen that is frequently difficult to directly visualize. The vertical body osteotomy is also made straighter by the same sagittal split cutting guide (Fig. 12). Conclusions: The Tri-Fix Orthognathic System is an Australian product that helps simplify and improve the accuracy of jaw corrective surgery (Figs. 13-15) while at the same time providing a fully digital platform from Figure 8: Intraoperative photo showing the completed LeFort 1 osteotomy. The pre-drilled holes are all visible where the bone screws will be placed to fix the maxilla with the custom bone plates. Figure 11: Intraopertive photo showing the 2 custom maxillary plates secured to the maxilla as planned on the computer image and facilitated by the custom drilling and cutting guide. Figure 12: Computer image of the innovative mandibular osteotomy cutting guide depicted in purple that accurately facilitates the medial ramus osteotomy cut to the lingula and the anterior vertical cut across the body of the mandible. Note the single hole along the external oblique ridge which is used to securely position the cutting guide with a bone screw. Figure 13: Lateral Cephalogram of the patient a few days following her bimaxillary osteotomy using the Tri-Fix Orthognathic System Figure 14: Patient profile 2 years following her bimaxillary osteotomy. Figure 15: Occlusal result 2 years following her bimaxillary osteotomy. Figure 9: Computer image showing the different screw lengths which are colour coded. The root tips of all the maxillary teeth are also displayed to ensure all the bone screws are positioned well away from the teeth. Figure 10: Computer image showing the osteotomized jaw segments in different colours. The pre-planned position of the custom maxillary plates are also shown in green. Figure 7: Once the initial osteotomy and all the drill holes are cut, the titanium guide is removed to complete the LeFort 1 osteotomy and downfracture. design to manufacture that competes well with other digital orthognathic systems available from foreign multi-national companies. ACKNOWLEDGEMENT: The TriFix™ Orthognathic System is made by MAXONIQ (www.maxoniq.com) and is TGA approved and fully rebateable on the Australian Register of Therapeutic Goods (ARTG) prosthesis schedule. DISCLOSURE: The author is the Founder and Clinical Director of MAXONIQ u
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