This article aims to determine the absolute accuracy of maxillary repositioning during orthognathic surgery according to simulation-guided navigation, that is, the combination of navigation and three-dimensional (3D) virtual surgery. We retrospectively studied 15 patients treated for asymmetric dentofacial deformities at the Oral and Maxillofacial Surgery Unit of the S.Orsola-Malpighi University Hospital in Bologna, Italy, from January 2010 to January 2012. Patients were scanned with a cone-beam computed tomography before and after surgery. The virtual surgical simulation was realized with a dedicated software and loaded on a navigation system to improve intraoperative reproducibility of the preoperative planning. We analyzed the outcome following two protocols: (1) planning versus postoperative 3D surface analysis; (2) planning versus postoperative point-based analysis. For 3D surface comparison, the mean Hausdorff distance was measured, and median among cases was 0.99 mm. Median reproducibility<1mm was 61.88% and median reproducibility<2mm was 85.46%. For the point-based analysis, with sign, the median distance was 0.75mm in the frontal axis, -0.05mm in the caudal-cranial axis, -0.35mm in the lateral axis. In absolute value, the median distance was 1.19mm in the frontal axis, 0.59mm in the caudal-cranial axis, and 1.02mm in the lateral axis. We suggest that simulation-guided navigation makes accurate postoperative outcomes possible for maxillary repositioning in orthognathic surgery, if compared with the surgical computer-designed project realized with a dedicated software, particularly for the vertical dimension, which is the most challenging to manage.

Navigation in Orthognathic Surgery: 3D Accuracy

Bianchi, A.;
2015

Abstract

This article aims to determine the absolute accuracy of maxillary repositioning during orthognathic surgery according to simulation-guided navigation, that is, the combination of navigation and three-dimensional (3D) virtual surgery. We retrospectively studied 15 patients treated for asymmetric dentofacial deformities at the Oral and Maxillofacial Surgery Unit of the S.Orsola-Malpighi University Hospital in Bologna, Italy, from January 2010 to January 2012. Patients were scanned with a cone-beam computed tomography before and after surgery. The virtual surgical simulation was realized with a dedicated software and loaded on a navigation system to improve intraoperative reproducibility of the preoperative planning. We analyzed the outcome following two protocols: (1) planning versus postoperative 3D surface analysis; (2) planning versus postoperative point-based analysis. For 3D surface comparison, the mean Hausdorff distance was measured, and median among cases was 0.99 mm. Median reproducibility<1mm was 61.88% and median reproducibility<2mm was 85.46%. For the point-based analysis, with sign, the median distance was 0.75mm in the frontal axis, -0.05mm in the caudal-cranial axis, -0.35mm in the lateral axis. In absolute value, the median distance was 1.19mm in the frontal axis, 0.59mm in the caudal-cranial axis, and 1.02mm in the lateral axis. We suggest that simulation-guided navigation makes accurate postoperative outcomes possible for maxillary repositioning in orthognathic surgery, if compared with the surgical computer-designed project realized with a dedicated software, particularly for the vertical dimension, which is the most challenging to manage.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/20.500.11769/365491
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