PDF herunterladen
Facial Plast Surg 2015; 31(05): 463-473
DOI: 10.1055/s-0035-1564716
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Navigation in Orthognathic Surgery: 3D Accuracy

Giovanni Badiali
1   Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
3   Oral and Maxillofacial Surgery Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
,
Andrea Roncari
2   Computational Bio-Engineering Laboratory, Rizzoli Orthopedic Institute, Bologna, Italy
,
Alberto Bianchi
3   Oral and Maxillofacial Surgery Unit, S.Orsola-Malpighi University Hospital, Bologna, Italy
,
Fulvia Taddei
4   Medical Technology Laboratory, Rizzoli Orthopedic Institute, Bologna, Italy
,
Claudio Marchetti
1   Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
,
Enrico Schileo
2   Computational Bio-Engineering Laboratory, Rizzoli Orthopedic Institute, Bologna, Italy
› Institutsangaben
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
18. November 2015 (online)

Auch verfügbar auf
    Lizenzen und Reprints

Abstract

This article aims to determine the absolute accuracy of maxillary repositioning during orthognathic surgery according to simulation-guided navigation, that is, the combination of navigation and three-dimensional (3D) virtual surgery. We retrospectively studied 15 patients treated for asymmetric dentofacial deformities at the Oral and Maxillofacial Surgery Unit of the S.Orsola-Malpighi University Hospital in Bologna, Italy, from January 2010 to January 2012. Patients were scanned with a cone-beam computed tomography before and after surgery. The virtual surgical simulation was realized with a dedicated software and loaded on a navigation system to improve intraoperative reproducibility of the preoperative planning. We analyzed the outcome following two protocols: (1) planning versus postoperative 3D surface analysis; (2) planning versus postoperative point-based analysis. For 3D surface comparison, the mean Hausdorff distance was measured, and median among cases was 0.99 mm. Median reproducibility < 1 mm was 61.88% and median reproducibility < 2 mm was 85.46%. For the point-based analysis, with sign, the median distance was 0.75 mm in the frontal axis, −0.05 mm in the caudal–cranial axis, −0.35 mm in the lateral axis. In absolute value, the median distance was 1.19 mm in the frontal axis, 0.59 mm in the caudal–cranial axis, and 1.02 mm in the lateral axis. We suggest that simulation-guided navigation makes accurate postoperative outcomes possible for maxillary repositioning in orthognathic surgery, if compared with the surgical computer-designed project realized with a dedicated software, particularly for the vertical dimension, which is the most challenging to manage.

Keywords

computer-aided surgery - image-guided surgery - simulation-guided surgery - maxillofacial orthognathic surgery - maxillofacial abnormalities
 

  • References

  • 1 Marchetti C, Bianchi A, Bassi M, Gori R, Lamberti C, Sarti A. Mathematical modeling and numerical simulation in maxillo-facial virtual surgery (VISU). J Craniofac Surg 2006; 17 (4) 661-667, discussion 668
    CrossrefPubMedGoogle Scholar
  • 2 Swennen GRJ, Mollemans W, Schutyser F. Three-dimensional treatment planning of orthognathic surgery in the era of virtual imaging. J Oral Maxillofac Surg 2009; 67 (10) 2080-2092
    CrossrefPubMedGoogle Scholar
  • 3 Zinser MJ, Sailer HF, Ritter L, Braumann B, Maegele M, Zöller JE. A paradigm shift in orthognathic surgery? A comparison of navigation, computer-aided designed/computer-aided manufactured splints, and “classic” intermaxillary splints to surgical transfer of virtual orthognathic planning. J Oral Maxillofac Surg 2013; 71 (12) 2151.e1-2151.e21
    CrossrefPubMedGoogle Scholar
  • 4 Adolphs N, Haberl E-J, Liu W, Keeve E, Menneking H, Hoffmeister B. Virtual planning for craniomaxillofacial surgery—7 years of experience. J Craniomaxillofac Surg 2014; 42 (5) e289-e295
    CrossrefPubMedGoogle Scholar
  • 5 Bianchi A, Muyldermans L, Di Martino M , et al. Facial soft tissue esthetic predictions: validation in craniomaxillofacial surgery with cone beam computed tomography data. J Oral Maxillofac Surg 2010; 68 (7) 1471-1479
    CrossrefPubMedGoogle Scholar
  • 6 Moerenhout BAMML, Gelaude F, Swennen GRJ, Casselman JW, Van Der Sloten J, Mommaerts MY. Accuracy and repeatability of cone-beam computed tomography (CBCT) measurements used in the determination of facial indices in the laboratory setup. J Craniomaxillofac Surg 2009; 37 (1) 18-23
    CrossrefPubMedGoogle Scholar
  • 7 Nadjmi N, Tehranchi A, Azami N, Saedi B, Mollemans W. Comparison of soft-tissue profiles in Le Fort I osteotomy patients with Dolphin and Maxilim softwares. Am J Orthod Dentofacial Orthop 2013; 144 (5) 654-662
    CrossrefPubMedGoogle Scholar
  • 8 Hassfeld S, Mühling J, Zöller J. Intraoperative navigation in oral and maxillofacial surgery. Int J Oral Maxillofac Surg 1995; 24 (1, Pt 2) 111-119
    CrossrefPubMedGoogle Scholar
  • 9 Ewers R, Schicho K, Undt G , et al. Basic research and 12 years of clinical experience in computer-assisted navigation technology: a review. Int J Oral Maxillofac Surg 2005; 34 (1) 1-8
    CrossrefPubMedGoogle Scholar
  • 10 Bell RB, Markiewicz MR. Computer-assisted planning, stereolithographic modeling, and intraoperative navigation for complex orbital reconstruction: a descriptive study in a preliminary cohort. J Oral Maxillofac Surg 2009; 67 (12) 2559-2570
    CrossrefPubMedGoogle Scholar
  • 11 Gordon CR, Murphy RJ, Coon D , et al. Preliminary development of a workstation for craniomaxillofacial surgical procedures: introducing a computer-assisted planning and execution system. J Craniofac Surg 2014; 25 (1) 273-283
    CrossrefPubMedGoogle Scholar
  • 12 Li B, Zhang L, Sun H, Shen SGF, Wang X. A new method of surgical navigation for orthognathic surgery: optical tracking guided free-hand repositioning of the maxillomandibular complex. J Craniofac Surg 2014; 25 (2) 406-411
    CrossrefPubMedGoogle Scholar
  • 13 Mazzoni S, Badiali G, Lancellotti L, Babbi L, Bianchi A, Marchetti C. Simulation-guided navigation: a new approach to improve intraoperative three-dimensional reproducibility during orthognathic surgery. J Craniofac Surg 2010; 21 (6) 1698-1705
    CrossrefPubMedGoogle Scholar
  • 14 Yu H, Shen SG, Wang X, Zhang L, Zhang S. The indication and application of computer-assisted navigation in oral and maxillofacial surgery-Shanghai's experience based on 104 cases. J Craniomaxillofac Surg 2013; 41 (8) 770-774
    CrossrefPubMedGoogle Scholar
  • 15 Ohba S, Yoshimura H, Ishimaru K, Awara K, Sano K. Application of a real-time three-dimensional navigation system to various oral and maxillofacial surgical procedures. Odontology 2015; 103 (3) 360-366
    CrossrefPubMedGoogle Scholar
  • 16 Swennen GRJ, Schutyser F, Hausamen JE, Van Cleynenbreugel J. Three-dimensional cephalometry: A color atlas and manual. Springer; 2005: 183-226
    Google Scholar
  • 17 Gribel BF, Gribel MN, Frazäo DC, McNamara Jr JA, Manzi FR. Accuracy and reliability of craniometric measurements on lateral cephalometry and 3D measurements on CBCT scans. Angle Orthod 2011; 81 (1) 26-35
    CrossrefPubMedGoogle Scholar
  • 18 Aspert N, Santa-Cruz D, Ebrahimi T. Mesh: measuring errors between surfaces using the Hausdorff distance, In: International Conference on Multimedia and Expo. Vol. 1. 2002: 705-708
    PubMedGoogle Scholar
  • 19 Viceconti M, Taddei F, Montanari L , et al. Multimod Data Manager: a tool for data fusion. Comput Methods Programs Biomed 2007; 87 (2) 148-159
    CrossrefPubMedGoogle Scholar
  • 20 Bouchard C, Landry P-É. Precision of maxillary repositioning during orthognathic surgery: a prospective study. Int J Oral Maxillofac Surg 2013; 42 (5) 592-596
    CrossrefPubMedGoogle Scholar
  • 21 Song K-G, Baek S-H. Comparison of the accuracy of the three-dimensional virtual method and the conventional manual method for model surgery and intermediate wafer fabrication. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 107 (1) 13-21
    CrossrefPubMedGoogle Scholar
  • 22 Zachow S, Hege H-C, Deuflhard P. Computer Assisted Planning in Cranio-Maxillofacial Surgery. J Comput Inf Technol 2006; 14 (1) 53-64
    PubMedGoogle Scholar
  • 23 Badiali G, Ferrari V, Cutolo F , et al. Augmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning. J Craniomaxillofac Surg 2014; 42 (8) 1970-1976
    CrossrefPubMedGoogle Scholar