“…Electromagnetic navigation has been successfully used in bronchoscopy and vascular interventions [24][25][26] , and its convenience and flexibility have been demonstrated. Previous studies had concluded that the accuracy of www.nature.com/scientificreports/ electromagnetic navigation in craniomaxillofacial surgery could meet the clinical needs and that the accuracy of assisted osteotomy in craniotomy and orthognathic surgery could equal that of optical navigation 27,28 . We have developed an effective tool for accurately translating virtual preoperative designs to the actual surgical environment by combining electromagnetic navigation with a surgical robot.…”
This study aimed to investigate the accuracy and safety of mandibular osteotomy and distraction device positioning in distraction osteogenesis assisted by an electromagnetic navigation surgical robot. Twelve New Zealand white rabbits were randomly divided into two groups after computed tomography. The control group underwent a procedure based on the preoperative three-dimensional design and clinical experience. Animals in experimental group underwent a procedure with robotic assistance after registration. The accuracies of osteotomy and distraction device positioning were analysed based on distance and angular errors. The change in ramus length after a 1 cm-extension of the distraction device was for assessing distraction effect. The preparation, operative and osteotomy times, intraoperative bleeding, and teeth injury were used for safety assessment. In the experimental group, the distance (t = 2.591, p = 0.011) and angular (t = 4.276, p = 0.002) errors of osteotomy plane, and the errors in distraction device position (t = 3.222, p = 0.009) and direction (t = 4.697, p = 0.001) were lower; the distraction effect was better (t = 4.096, p = 0.002). There was no significant difference in the osteotomy time and bleeding; however, the overall operative and preparation times were increased in the experimental group, with a reduced rate of teeth damage. Robot-assisted mandibular distraction osteogenesis with electromagnetic navigation in craniofacial microsomia is feasible, safe, significantly improves surgical precision.
“…Electromagnetic navigation has been successfully used in bronchoscopy and vascular interventions [24][25][26] , and its convenience and flexibility have been demonstrated. Previous studies had concluded that the accuracy of www.nature.com/scientificreports/ electromagnetic navigation in craniomaxillofacial surgery could meet the clinical needs and that the accuracy of assisted osteotomy in craniotomy and orthognathic surgery could equal that of optical navigation 27,28 . We have developed an effective tool for accurately translating virtual preoperative designs to the actual surgical environment by combining electromagnetic navigation with a surgical robot.…”
This study aimed to investigate the accuracy and safety of mandibular osteotomy and distraction device positioning in distraction osteogenesis assisted by an electromagnetic navigation surgical robot. Twelve New Zealand white rabbits were randomly divided into two groups after computed tomography. The control group underwent a procedure based on the preoperative three-dimensional design and clinical experience. Animals in experimental group underwent a procedure with robotic assistance after registration. The accuracies of osteotomy and distraction device positioning were analysed based on distance and angular errors. The change in ramus length after a 1 cm-extension of the distraction device was for assessing distraction effect. The preparation, operative and osteotomy times, intraoperative bleeding, and teeth injury were used for safety assessment. In the experimental group, the distance (t = 2.591, p = 0.011) and angular (t = 4.276, p = 0.002) errors of osteotomy plane, and the errors in distraction device position (t = 3.222, p = 0.009) and direction (t = 4.697, p = 0.001) were lower; the distraction effect was better (t = 4.096, p = 0.002). There was no significant difference in the osteotomy time and bleeding; however, the overall operative and preparation times were increased in the experimental group, with a reduced rate of teeth damage. Robot-assisted mandibular distraction osteogenesis with electromagnetic navigation in craniofacial microsomia is feasible, safe, significantly improves surgical precision.
“…Surgical navigation is comparable to a global positioning system (GPS) commonly used in automobiles and is composed of three primary components: a localizer, which is analogous to a satellite in space; an instrument or surgical probe, which represents the track waves emitted by the GPS unit in the vehicle; and a CT scan data set, which is analogous to a road map ( Figure 1 , Figure 2 ). Navigation systems were initially developed for use in neurosurgery and are now commonly used in craniomaxillofacial surgery because of the reliability and an accuracy of less than 1–2 mm [3] , [4] , [5] , [6] , [7] . Figure 1 Components of a surgical navigation system.…”
SummaryThe oral and maxillofacial region has a complicated anatomy with critical contiguous organs, including the brain, eyes, vital teeth, and complex networks of nerves and blood vessels. Therefore, advances in basic scientific research within the field of intraoperative oral and maxillofacial surgery have enabled the introduction of the features of these techniques into routine clinical practice to ensure safe and reliable surgery. A navigation system provides a useful guide for safer and more accurate complex in oral and maxillofacial surgery. The effectiveness of a navigation system for oral and maxillofacial surgery has been indicated by clinical applications in maxillofacial trauma surgery including complex midfacial fractures and orbital trauma reconstruction, foreign body removal, complex dentoalveolar surgery, skull base surgery including surgery of the temporomandibular joint (TMJ), and orthognathic surgery. However, some fundamental issues remain involving the mobility of the mandible and difficulty in updating images intraoperatively. This report presents an overview and feasible applications of available navigation systems with a focus on the clinical feasibility of the application of navigation systems in the field of oral and maxillofacial surgery and solutions to current problems.
“…Splints, guides, and custom-made plates are single-use medical devices with an environmental drawback. Intraoral navigation also requires preoperative planning and implies a specific installation in the operating theatre [ 16 , 21 ]. Furthermore, none of these devices allow for intraoperative adaptation in the same way as the mandibular on-site adjustment plates.…”
Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (PirifixTM) coupling these two functions during LFIO on 3D-printed models. Materials and Methods: DICOM data were selected from patients who underwent surgical planning for LFIO between 27 July 2020 and 1 December 2022. Their anatomy was reproduced after segmentation, planning, and stereolithography in two models. Each model was assigned to one of two surgical groups: the control group (positioning by occlusal splint) and the PirifixTM group. Each patient’s model was planned with the objective of horizontalizing and recentering the UDA. After positioning, models were digitalized using Einscan Pro 2X and compared to the planned model with CloudCompare. The statistical analysis was performed using the Wilcoxon Mann–Whitney test. The result was considered significant if the p-value was less than 0.05. Results: Twenty-one patients were selected. Forty-two anatomical models were 3D-printed. The mean difference compared to the planned and corrected positions was 0.69 mm for the control group and 0.84 mm for the PirifixTM group (p = 0.036). Conclusion: PirifixTM may be a new alternative to available MDs. Further investigations are needed to describe the relationship between the device and facial soft tissues.
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