Preliminary study of the accuracy and safety of robot-assisted mandibular distraction osteogenesis with electromagnetic navigation in hemifacial microsomia using rabbit models

Abstract

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.

Accuracy and safety of robotic navigation-assisted distraction osteogenesis for hemifacial microsomia

“…Accuracy results were compared with results from previous preliminary animal experiments via t -test (osteotomy positional error: 2 mm; osteotomy angular error: 10°; distractor positional error: 5 mm; distractor angular error: 7°) ( 13 ). α was set as 0.05 and (1 − β ) as 0.9.…”

Computerized Surgical Planning for Mandibular Distraction Osteogenesis

“…[37][38][39][40] Advances in virtual reality, artificial intelligence, and integration with robot-assisted surgeries continue to push the frontier of CSP's contribution to patient care. [41][42][43][44][45] Computerized Surgical Planning Workflow Accurate CSP requires high-resolution 3D imaging of the patient's mandible. Ideally, a computed tomography (CT) skull craniofacial protocol with slices no thicker than 1 mm is obtained.…”