Virtual planning and CAD/CAM-assisted distraction for maxillary hypoplasia in cleft lip and palate patients: Accuracy evaluation and clinical outcome

Gerbino, Giovanni; Autorino, Umberto; Giaccone, Elena; Novaresio, Andrea; Ramieri, Guglielmo

doi:10.1016/j.jcms.2021.03.004

Cited by 6 publications

(4 citation statements)

References 51 publications

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“…The effect of virtual surgical planning (VSP) combined with CAD/CAM splints has been demonstrated in several studies (15)(16)(17). However, the virtual footplates could not be contoured to conform to the 3D models, and the requirement of strong 3D visualization capabilities increased the difficulty of establishing the required vectors of movement during the VSP procedure (Figure 7) (18,19). On the contrary, prebending footplates and simulating distraction on the 3Dprinted patient skull phantom were more intuitive for surgeons (19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

“…However, the virtual footplates could not be contoured to conform to the 3D models, and the requirement of strong 3D visualization capabilities increased the difficulty of establishing the required vectors of movement during the VSP procedure ( Figure 7 ) ( 18 , 19 ). On the contrary, pre-bending footplates and simulating distraction on the 3D-printed patient skull phantom were more intuitive for surgeons ( 19 – 21 ). The CAD/CAM splint's low cost-efficient and excessive tissue dissection for its placement were another two issues that limited its clinical application ( 22 – 24 ).…”

Section: Discussionmentioning

confidence: 99%

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Augmented reality hologram combined with pre-bent distractor enhanced the accuracy of distraction vector transfer in maxillary distraction osteogenesis, a study based on 3D printed phantoms

Zhou

Jiang

et al. 2022

Front. Surg.

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BackgroundVector control is a significant concern in maxillary distraction osteogenesis (DO). Distraction vector planning on the patient's 3D-printed skull phantom is more intuitive for surgeons and cost-efficient than virtual surgical planning. However, the accuracy of transferring the planned vector to intraoperative (vector transfer) according to the shape of the pre-bent footplate alone is relatively limited. The application of augmented reality (AR) in surgical navigation has been studied for years. However, few studies have focused on its role in maxillary DO vector transfer. This study aimed to evaluate the accuracy of AR surgical navigation combined with the pre-bent distractor in vector transfer by comparing it with the pre-bent distractor alone.MethodsTen patients with maxillary hypoplasia were enrolled with consent, and three identical 3D-printed skull phantoms were manufactured based on per patient's corresponding pre-operative CT data. Among these, one phantom was for pre-operative planning (n = 10), while and the other two were for the AR+Pre-bending group (n = 10) and the Pre-bending group (n = 10) for the experimental surgery, respectively. In the Pre-bending group, the distraction vector was solely determined by matching the shape of footplates and maxillary surface. In the AR+Pre-bending group, the distractors were first confirmed to have no deformation. Then AR surgical navigation was applied to check and adjust the vector in addition to the steps as in the Pre-bending Group.ResultsFor the angular deviation of the distraction vector, the AR+Pre-bending group was significantly smaller than the Pre-bending group in spatial (p < 0.001), x-y plane (p = 0.002), and y-z plane (p < 0.001), and there were no significant differences in the x-z plane (p = 0.221). The AR+Pre-bending group was more accurate in deviations of the Euclidean distance (p = 0.004) and the y-axis (p = 0.011). In addition, the AR+Pre-bending group was more accurate for the distraction result.ConclusionsIn this study based on 3D printed skull phantoms, the AR surgical navigation combined with the pre-bent distractor enhanced the accuracy of vector transfer in maxillary DO, compared with the pre-bending technique alone.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Augmented reality hologram combined with pre-bent distractor enhanced the accuracy of distraction vector transfer in maxillary distraction osteogenesis, a study based on 3D printed phantoms

Zhou

Jiang

et al. 2022

Front. Surg.

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“…Recently, researchers have focused on the molecular mechanism of DOME in the treatment of cleft lip and palate, suggesting that fibroblasts in the zygomatic maxillary suture transform into a vascular endothelium-like state in response to mechanical stimulation, promoting angiogenesis under tension, while secreting signal molecules to interact with other cell types and promote osteogenesis ( 46 , 47 ). Further research is needed, however, on the mechanistic immune status of craniofacial sutures and the interactions between immune cells and other cell types ( 48 ). In terms of improved technology, 3D virtual surgical planning (VSP) and CAD/CAM technology can effectively reduce the total treatment time and allow patients to obtain a class I occlusion at the conclusion of the distraction ( 48 ) and the The use of a tooth-borne intraoral device in conjunction with the Mid-Maxillary Osteodistraction (MMOD) technique has been shown to be effective ( 49 ).…”

Section: Discussionmentioning

confidence: 99%

“…Further research is needed, however, on the mechanistic immune status of craniofacial sutures and the interactions between immune cells and other cell types ( 48 ). In terms of improved technology, 3D virtual surgical planning (VSP) and CAD/CAM technology can effectively reduce the total treatment time and allow patients to obtain a class I occlusion at the conclusion of the distraction ( 48 ) and the The use of a tooth-borne intraoral device in conjunction with the Mid-Maxillary Osteodistraction (MMOD) technique has been shown to be effective ( 49 ). However, the long-term stability of these improved techniques remains to be investigated.…”

Section: Discussionmentioning

confidence: 99%

A bibliometric analysis of research on craniomaxillofacial distraction osteogenesis from 2000 to 2021

Liu

Yang²,

Zhou³

et al. 2022

Front. Surg.

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ObjectiveThis study collected and summarized publications related to craniomaxillofacial distraction osteogenesis(DO) from 2000 to 2021, investigated trends in related research, and compared publications from different countries, institutions and journals. The aim is showcasing hotspots and frontiers in the field and providing a reference for future research.BackgroundCraniomaxillofacial DO serves to treat different types of craniomaxillofacial dysplasia and bone defects and deformities. DO can significantly reduce surgical trauma, complications, and recurrence rate compared to conventional surgery. However, there is a lack of bibliometric analyses regarding Craniomaxillofacial DO.MethodsCiteSpace and VOSviewer were used to analyze and visualize 3,141 articles and reviews searching through the Web of Science Core Collection(WOSCC) to obtain publications on craniomaxillofacial DO from 1 January 2000 to 31 December 2021.ResultsIn the last 21 years, there has been a significant increase in the number of publications. The United States, the People's Republic of China, and Italy produce the vast majority of publications. University of Milan and University of Bologna are the most influential in this field. McCarthy JG is the most influential author. Obstructive sleep apnea, TMJ ankylosis and cleft lip and palate are potential research direction in this field.ConclusionFuture research should focus on the precise indications and optimal timing of craniomaxillofacial DO and the evaluation of the long-term outcomes of various modified procedures. This study provides a relatively objective reference for related researchers, medical practitioners, and global health systems.

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Automatic orbital segmentation using deep learning-based 2D U-net and accuracy evaluation: A retrospective study

Morita,

Kawarazaki,

Koimizu

et al. 2023

Journal of Cranio-Maxillofacial Surgery

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Virtual planning and CAD/CAM-assisted distraction for maxillary hypoplasia in cleft lip and palate patients: Accuracy evaluation and clinical outcome

Cited by 6 publications

References 51 publications

Augmented reality hologram combined with pre-bent distractor enhanced the accuracy of distraction vector transfer in maxillary distraction osteogenesis, a study based on 3D printed phantoms

Augmented reality hologram combined with pre-bent distractor enhanced the accuracy of distraction vector transfer in maxillary distraction osteogenesis, a study based on 3D printed phantoms

A bibliometric analysis of research on craniomaxillofacial distraction osteogenesis from 2000 to 2021

Automatic orbital segmentation using deep learning-based 2D U-net and accuracy evaluation: A retrospective study

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