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

Area of Science:

• Oral and Maxillofacial Surgery
• Medical Robotics
• Image-Guided Surgery

Background:

• Current methods for repositioning the maxilla in orthognathic surgery have limitations in accuracy and require time-consuming laboratory work.
• Improving perioperative modification of maxillary position is crucial for reducing intraoperative errors.

Purpose of the Study:

• To evaluate the feasibility and accuracy of using a robot arm with intraoperative image-guided navigation for maxillary repositioning in orthognathic surgery.

Main Methods:

• Le Fort I osteotomy was performed on 12 full skull phantom models.
• A robot arm and image-guided navigation system were used to reposition the maxillary segment to a target position.
• Postoperative computed tomography (CT) was used to compare the achieved position with the planned position.

Main Results:

• Intraoperative navigation showed mean absolute deviations of less than 0.20 mm in all directions (medio-lateral, antero-posterior, supero-inferior).
• Postoperative CT analysis revealed mean absolute deviations of less than 0.5 mm for all dimensions.
• The mean root mean square deviation was 0.79 mm.

Conclusions:

• The combination of a robot arm and intraoperative image-guided navigation demonstrates high accuracy for maxillary repositioning.
• This technology shows significant potential for precise surgical plan transfer in orthognathic surgery.
• The system may offer a more efficient alternative to traditional methods, reducing the need for extensive laboratory processes.