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

Abstract

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.

In vitro and in vivo accuracy of autonomous robotic vs. fully guided static computer‐assisted implant surgery

“…36 The inherent error of the robotic arm was also the interfering factor of accuracy. 37 Additionally, the similarity between the two groups in resulting accuracy was CBCT examination. The error of CBCT data was determined by voxel size, exposure dose, imaging time, field of view size, image artifacts, and the movement of patients during the shooting process, which was the first step in data collection and the foundation for subsequent design and registration.…”

“…Robotic systems could achieve high accuracy in dental implant placement with an optical tracking system and robotic arm. 37 The optical system method provided automatic registration and calibration, resulting in higher accuracy and real-time dynamic adjustment. 36 Additionally, the system also could scan and record the micro motion of the jaw in real-time through visual navigation and then transmit the micro motion to the control system, sending instructions to control the end effector for fine-tuning and maintaining the surgery in accordance with the expected path.…”

“…Visual error meant deviations between the spatial coordinates recorded by the visual system when identifying marked points and the actual values, which was one of the main sources of the error in robot systems 36 . The inherent error of the robotic arm was also the interfering factor of accuracy 37 . Additionally, the similarity between the two groups in resulting accuracy was CBCT examination.…”

“…Robotic systems could achieve high accuracy in dental implant placement with an optical tracking system and robotic arm 37 . The optical system method provided automatic registration and calibration, resulting in higher accuracy and real‐time dynamic adjustment 36 .…”

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants—An Accuracy Study of Digital High-Tech Procedures

“…The application of robot-guided osteotomies in harvesting fibula flaps presents a promising prospect for achieving seamless integration within the surgical procedure [ 14 ]. A robotic arm with a navigation system offers numerous advantages in the field of bone cutting, as well as great potential in the three-dimensional repositioning of bones intraoperatively in complex reconstructions [ 23 ].…”