Navigation in Orthognathic Surgery: 3D Accuracy

Giovanni Badiali, Andrea Roncari, Alberto Bianchi, Fulvia Taddei, Claudio Marchetti, Enrico Schileo

Research output: Contribution to journalArticle

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 <1 mm was 61.88% and median reproducibility <2 mm was 85.46%. For the point-based analysis, with sign, the median distance was 0.75 mm in the frontal axis, -0.05 mm in the caudal-cranial axis, -0.35 mm in the lateral axis. In absolute value, the median distance was 1.19 mm in the frontal axis, 0.59 mm in the caudal-cranial axis, and 1.02 mm 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.

Original languageEnglish
Pages (from-to)463-473
Number of pages11
JournalFacial Plastic Surgery
Volume31
Issue number5
DOIs
Publication statusPublished - Oct 1 2015

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Keywords

  • computer-aided surgery
  • image-guided surgery
  • maxillofacial abnormalities
  • maxillofacial orthognathic surgery
  • simulation-guided surgery

ASJC Scopus subject areas

  • Surgery

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