Accuracy of experimental mandibular osteotomy using the image-guided sagittal saw

Pietruski, Piotr; Majak, Marcin; Świątek‐Najwer, Ewelina; Popek, Michał; Szram, Daniel; Żuk, Magdalena; Jaworowski, Janusz

doi:10.1016/j.ijom.2015.12.018

Cited by 31 publications

(19 citation statements)

References 38 publications

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“…Aside from CAD/CAM, intraoperative navigation is another CAS method that has been implemented for resection and reconstructive craniomaxillofacial surgery, albeit not to such degree as the former . In many aspects, the intraoperative navigation seems superior to the cutting guides, especially when an immediate reconstruction is required (Table ) .…”

Section: Discussionmentioning

confidence: 99%

“…Both methods proposed here may also find application in simultaneous mandibular resection and reconstruction (see Supporting Appendix 1, available online). The AR‐based navigation may be used for controlled excision of a mandibular fragment to obtain the defect with specific dimensions, which then undergoes a virtual repair with FFF . Using this algorithm, the whole preparation for CAS can be completed in 1 day, whereas designing, production, and delivery of cutting guides would take a few weeks.…”

Section: Discussionmentioning

confidence: 99%

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Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

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Objective: To analyze a novel navigation system utilizing augmented reality (AR) as a supporting method for fibula free flap (FFF) harvest and fabrication.Methods: A total of 126 simulated osteotomies supported with a cutting guide or one of two AR-based intraoperative navigation modules-simple AR (sAR) or navigated AR (nAR)-were carried out on 18 identical models of the fibula (42 osteotomies per method). After fusing postoperative computed tomography scans of the operated fibulas with the virtual surgical plan based on preoperative images, the objective outcomes-angular deviations from the planned osteotomy trajectory ( o ) and deviations of control points marked on the trajectory (mm)-were determined.Results: All analyzed methods provided similar accuracy of assisted osteotomies. The only significant difference referred to angular deviation in the sagittal plane, which was smaller after the cutting guide-assisted procedures than after the application of sAR and nAR (4.1 AE 2.29 vs. 5.08 AE 3.64 degrees, P = 0.031 and 4.1 AE 2.29 vs. 4.97 AE 2.91, P = 0.002, respectively). Mean deviation of control points after the cutting guide-assisted procedures was 2.76 AE 1.06 mm, as compared with 2.67 AE 1.09 mm for sAR and 2.95 AE 1.11 mm for nAR.Conclusion: Our study demonstrated that both novel AR-based methods provided similar accuracy of assisted harvesting and contouring of the FFF as the cutting guides. This fact, as well as the acceptability of the concept by clinicians, justify their further development and evaluation in preclinical settings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

et al. 2019

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“…Virtual planning leverages advances in the field of computer‐aided design (CAD)/computer‐aided manufacturing (CAM), which have led to the development of patient‐specific, prefabricated cutting guides and reconstruction plate templates . Surgical navigation systems based on preoperative imaging data (e.g., computed tomography [CT], magnetic resonance) are in widespread use in sinus and skull base surgery and are now increasingly used for guidance of head and neck resection and reconstruction . Notwithstanding the demonstrated clinical benefits of preoperative virtual planning and surgical navigation, both techniques have potential limitations because they are reliant on the use of preoperative imaging data, which may not account for morphological changes due to surgical excision, anatomical deformation, and tumor growth.…”

Section: Introductionmentioning

confidence: 99%

Intraoperative cone‐beam CT‐guided osteotomy navigation in mandible and maxilla surgery

et al. 2019

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Objectives: Surgical navigation systems based on preoperative imaging are now increasingly used for guidance of head and neck resection and reconstruction. The primary aim of this study was to quantify osteotomy cutting accuracy using an image-guidance system for intraoperative cone-beam computed tomography (CBCT) imaging and surgical saw navigation. To enable clinical translation of this CBCT-guided navigation system, a secondary aim of the study was to design and fabricate a patient reference tracker suitable for clinical use on a mobile mandible.Methods: First, a preclinical cadaveric study was performed to quantify navigation accuracy with the use of clinically suitable patient reference trackers. Second, a proof-of-principle patient study was conducted to evaluate this technique under clinical conditions.Results: In both preclinical (5 cadavers) and clinical (5 patients) experiments, the mean cutting accuracy was less than 2 mm. In all preclinical specimens, bilateral mandibulectomies and bilateral maxillectomies were performed, for a total of 20 cut planes for analysis. The mean (standard deviation [SD]) values for distance, pitch, and roll were 1.4 mm (1.1 mm), 4.2 (3.5 ), and 2.9 (2.5 ) mm, respectively. Five mandibulectomies were performed on five patients, for a total of 10 cut planes for analysis. The mean (SD) values for distance, pitch, and roll were 1.7 mm (0.8 mm), 5.4 (1.5 ), and 6.7 (4.6 ) mm, respectively.Conclusions: The overall performance in comparison to alternative approaches warrants further consideration. In terms of accuracy, the results presented here are comparable to recent systematic reviews assessing CAD-CAM cutting guides that cite accuracies of~2 to 2.5 mm.

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“…17,18 In this situation, resection is done, consisting of the removal of the part of the mandible bone affected by the tumour. 19,20 Without correct joining of discontinued sections of the mandible, the patency of the respiratory tracts is impaired, disorders of swallowing occur, and speech and chewing together with the lower part of the facial section are deformed. In order to partially avoid the above-mentioned problems, titanium plates are used to join discontinued sections of the mandible (Figure 1(b)).…”

Section: Introductionmentioning

confidence: 99%

“…21,22 Usually, the free fibula flap or free iliac crest flap is also fixed to a titanium plate, allowing for increase in the functionality of the mandible after bone resection. 17,20 However, literature analysis shows that increasing the precision of geometry reconstruction within the skull area at the stage of design [23][24][25][26] and manufacture of anatomical models need to be enabled. 27,28 There are currently no tests in this field carried out on a larger group of patients.…”

Section: Introductionmentioning

confidence: 99%

Elaboration of the measuring procedure facilitating precision assessment of the geometry of mandible anatomical model manufactured using additive methods

Budzik

Turek

Dziubek

et al. 2019

Measurement and Control

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This article presents a procedure for minimizing ATOS II Triple Scan system measurement errors during the verification of geometrical accuracy of the final lateral-mandibular condyle model. The process of manufacturing a template geometrically similar to that of lateral-mandibular condyle was performed on the five-axis machining centre 100 DMU MonoBlock. The next stage of the research was related to the implementation of the measurement system procedure on the template model, and the 12 anatomical models of the mandibular body-condyle were manufactured using five different additive methods. As a result of the comparison of anatomical models of the mandibular body-condyle designed in reverse engineering/computer-aided design systems and manufactured using additive methods, the average results of histograms and parameters determining the accuracy of geometry of 12 models were obtained. In the case of models manufactured using fused deposition modelling, PolyJet and selective laser sintering techniques, a unimodal distribution was observed in the same way as in the template model. The best results were obtained in the case of models manufactured using selective laser sintering techniques (standard deviation = 0.06 mm). In the case of fused deposition modelling and PolyJet, a similar value of standard deviation (about 0.07 mm) was observed, despite the fact that the layer thickness for PolyJet technology was 0.016 mm. In the case of melted and extruded modelling and ColorJet Printing technologies, there was a bimodal distribution. Through the implementation of own template and measurement method, it will be easier to estimate errors in the manufacturing of anatomical models of lateral-mandibular condyle part. As a result, medical models, surgical templates and implants will be manufactured more accurately and precisely, which will significantly reduce intraoperative complications during the surgical procedure in this area.

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Accuracy of experimental mandibular osteotomy using the image-guided sagittal saw

Cited by 31 publications

References 38 publications

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Supporting fibula free flap harvest with augmented reality: A proof‐of‐concept study

Intraoperative cone‐beam CT‐guided osteotomy navigation in mandible and maxilla surgery

Elaboration of the measuring procedure facilitating precision assessment of the geometry of mandible anatomical model manufactured using additive methods

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