Feasibility of Mandibular Distraction Osteogenesis Using Mixed Reality-based Dynamic Navigation: A Preclinical Study

Area of Science:

• Surgical Navigation Technologies
• Medical Imaging and Visualization
• Orthognathic Surgery

Background:

• Mandibular distraction osteogenesis (MDO) is essential for treating mandibular hypoplasia.
• Mixed reality (MR) offers potential advantages over traditional surgical navigation methods.
• Limited evidence exists on the efficacy of MR navigation in MDO procedures.

Purpose of the Study:

• To develop and evaluate a dynamic MR-based navigation system for MDO.
• To compare the performance of the MR system against surgical guides (SG), freehand (FH), and traditional navigation (TN) techniques.

Main Methods:

• Developed an adjacent-display MR navigation system with optical tracking and patient-specific registration.
• Evaluated system accuracy using 3D-printed mandibular models (n=30) and animal studies in Beagle dogs (n=32).
• Assessed feasibility and accuracy in 10 human cadaver heads, measuring osteotomy accuracy, distraction-vector deviation, and operative time.

Main Results:

• MR navigation demonstrated superior distractor and osteotomy accuracy compared to the freehand (FH) approach in model experiments.
• In animal studies, the MR system outperformed FH and surgical guide (SG) approaches in distractor positioning and osteotomy accuracy.
• MR navigation reduced operative time and improved accuracy compared to traditional navigation (TN) in cadaver experiments.

Conclusions:

• The developed dynamic MR navigation system provides enhanced accuracy for MDO.
• MR navigation shows specific advantages over traditional navigation (TN) and surgical guide (SG) based methods.
• The system holds significant potential for precise clinical application in MDO.