Novel electromagnetic-navigated maxillary repositioning system for Le Fort I osteotomy: preclinical evaluation

Advances in assistive technologies for orthognathic surgery have increased the prevalence of guided surgeries. In this study, we developed and evaluated a novel system utilising electromagnetic (EM) navigation for maxillary positioning. Le Fort I osteotomies were performed on three skull models. The three-dimensional position of two sensors, facilitated by an EM tracking system, was used to move and fix the maxilla into its planned position, shifted 3 mm forward. The first sensor was placed on the lateral border of the pyriform aperture on the cranial side, while the second sensor was affixed as a splint on the maxillary dentition. Surface data from scans of the experimental skull bone were obtained using an optical scanner and superimposed on the pre-planned data to assess accuracy. The discrepancy between the maxilla positioned with EM navigation and the planned position was within 1.0 mm in the vertical, horizontal, and anteroposterior directions. Error at the A and ANS measurement points was 0.44 and 0.54 mm mean, 0.32 and 0.38 SD, 0.38 and 0.47 mm median, respectively This experimental study represents a paradigm shift from guided to navigation surgery. Meticulous maxillary repositioning achieved through EM navigation enhances the reproducibility of preoperative simulations during surgery.