Precision of a CAD/CAM–engineered surgical template based on a facebow for orthognathic surgery: an experiment with a rapid prototyping maxillary model

Lee, Jae Won; Lim, Se-Ho; Kim, Moon-Key; Kang, Sang-Hoon

doi:10.1016/j.oooo.2015.07.007

Cited by 8 publications

(3 citation statements)

References 14 publications

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“…Various surgical devices have been developed to connect intact anatomic structures other than the maxillary and mandibular jaws, which are displaced during surgery. Lee et al [7] examined the precision of a CAD/CAM facebow-based surgical guide template by comparing it with a bite wafer and found significant intergroup differences in lateral error compared with the absolute values of the 3D linear distance. Thus, it can be seen that artefacts of 3D volumetric surface can degrade the precision of orthognathic surgery design.…”

Section: Introductionmentioning

confidence: 99%

Accuracy of in vitro mandibular volumetric measurements from CBCT of different voxel sizes with different segmentation threshold settings

et al. 2019

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Background To determine the accuracy of volumetric measurements of the mandible in vitro by cone-beam computed tomography (CBCT) and to analyze the influence of voxel sizes and segmentation threshold settings on it. Methods The samples were obtained from pig mandibles and scanned with 4 voxel sizes: .125 mm, .20 mm, .30 mm, and .40 mm. The minimum segmentation thresholds in Hounsfield units (HU) were set as 0, 100, 200, 300, and 400, respectively, for each voxel size for 3D reconstruction. Laser scanning as the reference, the volumes of each CBCT scanning, the mean iterative distances of superimposition and total positive and negative deviations were recorded and compared. Results The volumes of CBCT-scan deviated from those of laser-scan by + 7.67% to − 3.05% with different HU and voxel sizes. The deviation increased with the voxel size. There was a more suitable minimum HU threshold of segmentation (HU100 for .125 mm, 200 for .20 mm, 300 for .30 mm, and 400 for .40 mm) for each voxel size. Conclusions Voxel sizes and Hounsfield unit thresholds influence the accuracy of volumetric measurements in CBCT scanning. The volume increase with the voxel size, and different voxel sizes correspond to different optimal Hounsfield unit thresholds.

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Section: Introductionmentioning

confidence: 99%

Accuracy of in vitro mandibular volumetric measurements from CBCT of different voxel sizes with different segmentation threshold settings

et al. 2019

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“…Since collecting and analyzing patient data are the required parameters, it can be stated that one of the prominent applications of AM technology, in the medical industry, is the design and fabrication of patient-specific guides to perform drilling and cutting operations. [6][7][8][9][10][11] In this research, the drilling operation in spine surgery is considered.…”

Section: Introductionmentioning

confidence: 99%

A low invasiveness patient’s specific template for spine surgery

Azimifar

Hassani

Saveh

et al. 2016

Proc Inst Mech Eng H

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Free-hand pedicle screw placement is still conventional in surgery, although it has potentially high risks. The surgical procedures such as pedicle screw placement are usually designed based on medical imaging, but during surgery, the procedures are not normally followed due to the fact that some points are missed in two-dimensional images and seen only during surgery. In this regards, some highly accurate computer-assisted systems have been proposed and are currently used. Moreover, it is possible to reduce or completely avoid hand working by applying modern digital technology. Therefore, using these technologies has remarkable advantages. In this study, we have presented a new approach of pedicle screw placement in the lumbar and sacral regions using a specific drill guide template. The template was created by additive manufacturing technology and was verified in a clinical study as well. The main aim of this research includes the following: design, analyze, manufacture and evaluate the accuracy of a new patient-specific drill guide template, for lumbar pedicle screw placement, and compare the template to the free-hand technique under fluoroscopy supervision. Our results show that the incidence of cortex perforation is substantially reduced compared to existing methods. Finally, we believe that this approach remarkably lowers the incidence of cortex perforation and could be potentially used in clinical applications, particularly in certain selected cases.

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“…In addition, surgeons have been always looking for better ways to understand and diagnose conditions of individual patients. Fortunately, diagnostic tools are accessible and the latest computed tomography (CT), MRI, and other medical imaging technology can now provide patient data in many ways with great clarity and accuracy .…”

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confidence: 99%

A New Template and Teleoperation System for Human‐Guided Spine Surgery

et al. 2018

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Fluoroscopy-guided placement of pedicle screws is usually used to position pedicle screws, although it is highly risky due to lack of accuracy during operation and surgeon's intensive labor requirement during surgery. In this study, a new method was introduced to consider the issues and we tried to reduce the risk of pedicle screw placement and drilling process. To put pedicle screws in the correct position and orientation, a specific drill guide is designed and fabricated by additive manufacturing technology. In addition, since the drilling process is remarkably important and it is usually dependent on surgeon skill, therefore a teleoperation system is proposed to perform this task. In order to let the surgeon to have better control on the patient, a control scheme including position and velocity signals along with surgeon force and reaction force of vertebra was proposed. This helped the surgeon for proper control on the patient during surgery. A force estimation algorithm was presented to eliminate measuring external force signal. Consequently, 10 vertebras were used to evaluate specific drill guide and teleoperation system simultaneously. Then, the computed tomography evaluation demonstrated that Kirschner wire trajectories followed the planned axes with an error between 1 and 2 mm in 20% of cases and less than 1 mm in 80% of cases. The results obtained by the teleoperation system showed that the surgeon, in the master side, has proper control over the patient body in the slave side because the slave robot followed the master position. Furthermore, the surgeon in the master side sensed the reaction force of vertebra in the slave side appropriately.

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Precision of a CAD/CAM–engineered surgical template based on a facebow for orthognathic surgery: an experiment with a rapid prototyping maxillary model

Cited by 8 publications

References 14 publications

Accuracy of in vitro mandibular volumetric measurements from CBCT of different voxel sizes with different segmentation threshold settings

Accuracy of in vitro mandibular volumetric measurements from CBCT of different voxel sizes with different segmentation threshold settings

A low invasiveness patient’s specific template for spine surgery

A New Template and Teleoperation System for Human‐Guided Spine Surgery

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