Purpose: The purpose of this retrospective study is to evaluate the accuracy of soft tissue prediction models with Dolphin Imaging. Materials and Methods: Preoperative and 1-year postoperative Lateral cephalograms (LCG) of patients undergoing Le Fort I, bilateral sagittal split osteotomy (BSSO) or bimaxillary osteotomy (Bimax) between 2006 and 2009 were retrospectively collected. A hard tissue virtual surgery was performed on the preoperative LCG to match the hard tissue of the 1-year postoperative LCG. The soft tissue changes were then modelled by Dolphin Imaging (version 11.5b) and the differences in x- and y-coordinates of 11 hard tissue and 14 soft tissue landmarks between the predicted model and 1-year postoperative LCG were determined. Statistical analyses were performed using a one-tailed, one-sample t-test for both soft- and hard tissue differences, and a Bland-Altman plot for interobserver bias. Results: A total of 108 patients were included, the mean age was 30 years and 23% were male. The virtual treatment was considered accurate; all hard tissue landmark differences were less than 1 mm. The soft tissue model by Dolphin Imaging showed significant differences of more than 2 mm for several landmarks, including the vertical positioning of Stomion Inferius (P = 0.007), Lower lip (P = 0.005) and Pogonion (P = 0.03) in the Bimax group and horizontal positioning of Stomion Inferius (P < 0.001) in the BSSO group. Conclusions: Dolphin Imaging gives reasonable predictions of postoperative outcome. There is, however, room for improvement, especially regarding the vertical prediction in the lower lip region.

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Keywords Cephalometry, Computer Simulation, Orthognathic Surgical Procedures, Treatment Outcome
Persistent URL dx.doi.org/10.1016/j.ortho.2019.06.008, hdl.handle.net/1765/117910
Journal International Orthodontics
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van Twisk, P.H, Tenhagen, M. (Maik), Gül, A, Wolvius, E.B, & Koudstaal, M.J. (2019). How accurate is the soft tissue prediction of Dolphin Imaging for orthognathic surgery. International Orthodontics. doi:10.1016/j.ortho.2019.06.008