Supporting mandibular resection with intraoperative navigation utilizing augmented reality technology - A proof of...

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Navigation Technologies
• Medical Imaging and Simulation

Background:

• Accurate mandibular osteotomies are crucial for successful reconstructive and resection procedures.
• Intraoperative navigation systems aim to improve surgical precision.
• Augmented reality (AR) technology offers potential for enhanced surgical guidance.

Purpose of the Study:

• To compare the accuracy of simulated mandibular osteotomies using cutting guides versus two AR-based navigation systems (simple AR and navigated AR).

Main Methods:

• 126 osteotomies were performed on mandible models based on virtual surgical plans.
• Postoperative CT scans were fused with preoperative scans for outcome analysis.
• Accuracy was assessed by measuring angular deviations and control point displacements.

Main Results:

• Cutting guides yielded the highest accuracy (mean angular deviation: 4.94° ± 4.62°, displacement: 1.65 mm ± 0.88 mm).
• Simple AR (sAR) and navigated AR (nAR) systems showed lower accuracy (sAR: 5.34° ± 3.67°, 1.79 mm ± 0.94 mm; nAR: 7.14° ± 5.19°, 2.41 mm ± 1.34 mm).

Conclusions:

• Cutting guides remain the most accurate method for simulated mandibular osteotomies.
• AR navigation systems show promise for improving surgeon awareness and hand-eye coordination.
• Further development of AR technology is necessary for widespread clinical adoption in mandibular surgery.