Real-time augmented model guidance for mandibular proximal segment repositioning in orthognathic surgery, using electromagnetic tracking

Lee, SangJeong; Yang, Hye-Won; Choi, Minsuk; Woo, Sang-Yoon; Huh, Kyung-Hoe; Heo, Min-Suk; Choi, Soon-Chul; Hwang, Soon Jung; Yi, Won-Jin

doi:10.1016/j.jcms.2018.10.016

Cited by 19 publications

(27 citation statements)

References 61 publications

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“…The computer-assisted navigation system often consisted of several optical localizers and provided surgeons with quantitative and intuitive screen outcomes, achieving immediate intraoperative revise of condylar malpositioning without mechanical stress. 5,28,29,35,36 However, the localizers attaching to the bone once loosened after osteotomy, the navigation system had to abort. 5 Due to the instability of sensors, the navigation system was recommended for senior surgeons in difficult cases.…”

Section: Computer-assisted Navigation Systemmentioning

confidence: 99%

Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Chow

Liu

et al. 2022

Orthod Craniofacial Res

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Purpose The surgical condylar displacement often resulted in relapse and serious symptoms of temporomandibular joint disorders (TMD) after orthognathic surgery. To minimize the displacement, numerous techniques have been proposed. To verify their accuracy in positioning and effectiveness in preventing post‐operative TMD and relapse, we reviewed the literature related to intraoperative condylar positioning techniques on the mandible in this study. Methods The literature on condylar positioning techniques was reviewed with two charts, including the non‐computer‐assisted and the computer‐assisted positioning methods. The pre‐ and post‐operative alterations of condyles, the post‐operative temporomandibular joint (TMJ) function and surgical relapse were analysed regarding the techniques. The clinical usage and characteristics were reviewed as well. Results A total of 22 articles, including 907 patients, have been reported since 2001. Nearly all methods reach a considerable positioning accuracy within the range of 1‐2 mm and 1‐2° from the pre‐operative position. We ranked the accuracy of the methods from high to low: CAD/CAM CPDs > CAD/CAM titanium plate positioning > manual positioning > computer‐assisted navigation systems > imaging positioning systems. Most skeletal class II and class III patients achieved great occlusion and had no TMJ dysfunction or relapse after condylar positioning. Conclusions Both the non‐computer‐assisted and computer‐assisted condylar positioning techniques reach considerable accuracy in locating the pre‐operative condyle position and preventing TMJ dysfunction and surgical relapse. Different levels of surgeons and cases can benefit from multiple suggested positioning methods. Further research with large samples and long‐term follow‐up is worth looking forward to upgrading the current methods, improving the clinical utility and developing new positioning techniques.

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Section: Computer-assisted Navigation Systemmentioning

confidence: 99%

Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Chow

Liu

et al. 2022

Orthod Craniofacial Res

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“…Previously, we reported an orthognathic surgery system using an image-guided navigation using optical tracking or electromagnetic tracking, and the navigation-based orthognathic surgery could help to accurately reposition the maxilla in the target position [13,27]. Mazzoni et al [28] reported that preoperative surgical plan reproducibility was 86.5% with the help of intraoperative navigation based on the optical tracking, and 80% without the navigation.…”

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

Han

Woo

et al. 2021

JCM

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Several methods enabling independent repositioning of the maxilla have been introduced to reduce intraoperative errors inherent in the intermediate splint. However, the accuracy is still to be improved and a different approach without time-consuming laboratory process is needed, which can allow perioperative modification of unoptimized maxillary position. The purpose of this study is to assess the feasibility and accuracy of a robot arm combined with intraoperative image-guided navigation in orthognathic surgery. The experiments were performed on 12 full skull phantom models. After Le Fort I osteotomy, the maxillary segment was repositioned to a different target position using a robot arm and image-guided navigation and stabilized. Using the navigation and the postoperative computed tomography (CT) images, the achieved maxillary position was compared with the planned position. Although the maxilla showed mild displacement during the fixation, the mean absolute deviations from the target position were 0.16 mm, 0.18 mm, and 0.20 mm in medio-lateral, antero-posterior, and supero-inferior directions, respectively, in the intraoperative navigation. Compared with the target position using postoperative CT, the achieved maxillary position had a mean absolute deviation of less than 0.5 mm for all dimensions and the mean root mean square deviation was 0.79 mm. The results of this study suggest that the robot arm combined with the intraoperative image-guided navigation may have great potential for surgical plan transfer with the accurate repositioning of the maxilla in the orthognathic surgery.

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“…To obtain skeletal models with artifact-free, high-resolution dentitions, the dental plaster casts of the patients were scanned using an optical model scanner (Maestro 3D, Maestro, Pisa, Italy) [23] and the scanned dentitions were fused with the corresponding maxillary and mandibular models using a modified iterative closest point (ICP) algorithm combined with a coherent point drift (CPD) algorithm [24][25][26][27][28]. A k-dimensional tree algorithm was used to accelerate and optimize the ICP algorithm process used for finding the closest points in the corresponding models by searching for the nearest neighbors [29].…”

Section: Acquisition Of Patients' Ct and 3d Dentition Datamentioning

confidence: 99%

A Complete Digital Workflow for Planning, Simulation, and Evaluation in Orthognathic Surgery

Lee

Yoo

Woo

et al. 2021

JCM

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The purpose of this study was to develop a complete digital workflow for planning, simulation, and evaluation for orthognathic surgery based on 3D digital natural head position reproduction, a cloud-based collaboration platform, and 3D landmark-based evaluation. We included 24 patients who underwent bimaxillary orthognathic surgery. Surgeons and engineers could share the massive image data immediately and conveniently and collaborate closely in surgical planning and simulation using a cloud-based platform. The digital surgical splint could be optimized for a specific patient before or after the physical fabrication of 3D printing splints through close collaboration. The surgical accuracy was evaluated comprehensively via the translational (linear) and rotational (angular) discrepancies between identical 3D landmarks on the simulation and postoperative computed tomography (CT) models. The means of the absolute linear discrepancy at eight tooth landmarks were 0.61 ± 0.55, 0.86 ± 0.68, and 1.00 ± 0.79 mm in left–right, advance–setback, and impaction–elongation directions, respectively, and 1.67 mm in the root mean square direction. The linear discrepancy in the left–right direction was significantly different from the other two directions as shown by analysis of variance (ANOVA, p < 0.05). The means of the absolute angular discrepancies were 1.43 ± 1.06°, 0.50 ± 0.31°, and 0.58 ± 0.41° in the pitch, roll, and yaw orientations, respectively. The angular discrepancy in the pitch orientation was significantly different from the other two orientations (ANOVA, p < 0.05). The complete digital workflow that we developed for orthognathic patients provides efficient and streamlined procedures for orthognathic surgery and shows high surgical accuracy with efficient image data sharing and close collaboration.

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Real-time augmented model guidance for mandibular proximal segment repositioning in orthognathic surgery, using electromagnetic tracking

Cited by 19 publications

References 61 publications

Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Intraoperative condylar positioning techniques on mandible in orthognathic surgery

Robot-Assisted Maxillary Positioning in Orthognathic Surgery: A Feasibility and Accuracy Evaluation

A Complete Digital Workflow for Planning, Simulation, and Evaluation in Orthognathic Surgery

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