Replacing cutting guides with an augmented reality-based navigation system: A feasibility study in the maxillofacial...

Area of Science:

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

Background:

• Maxillofacial osteotomies are critical surgical procedures requiring high precision.
• Traditional cutting guides and emerging augmented reality (AR) navigation systems are used to enhance surgical accuracy.
• Evaluating the comparative accuracy of these methods is essential for optimizing surgical outcomes.

Purpose of the Study:

• To compare the accuracy of cutting guides, simple augmented reality (sAR), and navigated augmented reality (nAR) systems in simulated maxillofacial osteotomies.
• To quantify deviations in angular trajectory and control point positioning for each method.

Main Methods:

• Fifteen skull models underwent simulated osteotomies using a cutting guide, sAR, or nAR system, with five models per method.
• Each method supported 40 upper jaw and 40 orbital region osteotomies.
• Postoperative CT scans were analyzed against the virtual surgical plan (VSP) to measure angular and linear deviations.

Main Results:

• Cutting guides demonstrated the highest accuracy, with mean angular deviation of 3.73° ± 2.94° and mean control point deviation of 1.30 mm ± 0.73 mm.
• Simple AR (sAR) resulted in mean angular deviation of 5.93° ± 5.12° and control point deviation of 1.86 mm ± 0.88 mm.
• Navigated AR (nAR) showed mean angular deviation of 6.75° ± 5.33° and control point deviation of 1.97 mm ± 0.70 mm.

Conclusions:

• Cutting guides provide superior accuracy for simulated maxillofacial osteotomies compared to both sAR and nAR systems.
• While AR navigation offers potential benefits, current iterations show lower precision than traditional cutting guides for these specific simulated procedures.
• Further development of AR navigation systems may be needed to match or exceed the accuracy of established cutting guide techniques.