Overcoming the Limitations of Conventional Orthognathic Surgery: A Novel Approach Using Implate

Abstract

Introduction: This manuscript addresses the limitations of traditional orthognathic surgery in achieving both functional and aesthetic correction in patients with Class II malocclusion and severe mandibular retrusion. Current techniques often struggle to simultaneously address mandibular deficiency and inadequate transverse dimension, leading to unsatisfactory outcomes. Methods: Seven male patients underwent bimaxillary osteotomy with mandibular advancement. A novel surgical plate, Implate, was used, which was designed to facilitate precise osteotomy and stabilization. Pre-surgical planning included CBCT scanning, 3D modeling, and surgical simulation. Postoperative assessments included clinical examinations, CT and OPT scans. Results: Implate successfully addressed the challenges of conventional techniques, minimizing the formation of bony steps and achieving a more harmonious facial profile. The minimally invasive procedure, with careful periosteal and muscle management, contributed to stable outcomes, and no complications were reported. At the 6-month follow-up, OPT analysis showed a mean mandibular width increase of 18.1 ± 6.2 mm and vertical ramus height gains of 6.0 ± 3.1 mm (left) and 5.8 ± 1.7 mm (right). Conclusions: According to our preliminary experience, the integration of Implate into surgical practice offers a significant improvement in treating complex Class II malocclusions. By simultaneously correcting mandibular retrusion and width while minimizing complications, Implate provides a superior solution compared to traditional methods. This innovative approach highlights the potential of combining advanced surgical techniques with personalized 3D-printed implants to achieve optimal functional and aesthetic outcomes. Further prospective studies with controls and longer follow-up are needed to validate the efficacy and reproducibility of Implate in wider clinical use.