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Virtual skeletal complex model- and landmark-guided orthognathic surgery system.

Sang-Jeong Lee1, Sang-Yoon Woo1, Kyung-Hoe Huh2

  • 1Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea.

Journal of Cranio-Maxillo-Facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery
|March 26, 2016
PubMed
Summary

This study introduces a novel virtual surgical guidance system for orthognathic surgery. It accurately guides bone repositioning using 3D models, improving surgical outcomes for maxillofacial deformities.

Keywords:
3D registrationOrthognathic surgeryVirtual model- and landmark-guided transferVirtual skeletal complex modelVirtual surgery planning

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Medical Imaging
  • Computer-Aided Surgery

Background:

  • Orthognathic surgery corrects maxillofacial deformities through bone repositioning.
  • Accurate preoperative planning and intraoperative guidance are crucial for successful outcomes.
  • Current navigation systems may lack real-time, quantitative feedback for bone segment alignment.

Purpose of the Study:

  • To develop and evaluate a virtual surgical guidance system for bimaxillary orthognathic surgery.
  • To provide intraoperative visualization and quantification of deviations from the planned surgical outcome.
  • To enhance the accuracy and flexibility of bone repositioning during surgery.

Main Methods:

  • Virtual surgical planning using patient-specific 3D skeletal and dental models.
  • Generation of a virtual maxillomandibular complex (MMC) model representing the final occlusal relationship.
  • Intraoperative registration and real-time visualization of the surgical state against the goal model.
  • Quantitative display of deviation errors for landmarks and the MMC.

Main Results:

  • The system achieved a root mean square (RMS) difference of 1.16 ± 0.34 mm between planned and intraoperative positions immediately after repositioning.
  • Postoperative RMS differences were 1.31 ± 0.28 mm for maxillary and 1.74 ± 0.73 mm for mandibular landmarks.
  • Surgeons could easily recognize and correct 3D deviations, improving guidance for bone repositioning.

Conclusions:

  • The developed virtual guidance system offers accurate and flexible intraoperative navigation for bimaxillary orthognathic surgery.
  • Real-time visualization and quantification of deviations enhance surgical precision.
  • This approach complements conventional navigation, improving bone repositioning in craniomaxillofacial surgery.