Image-guided bone resection as a prospective alternative to cutting templates—A preliminary study

• Published in: Journal of cranio-maxillo-facial surgery Vol. 43; no. 7; pp. 1021 - 1027
• Main Authors: Pietruski, Piotr, Majak, Marcin, Światek-Najwer, Ewelina, Popek, Michal, Jaworowski, Janusz, Zuk, Magdalena, Nowakowski, Filip
• Format: Journal Article
• Language: English
• Published: Scotland Elsevier Ltd 01.09.2015
• Subjects: Alveolar Process - surgery; Bone-cutting templates; Computer-Aided Design; Computer-assisted surgery; Craniomaxillofacial resection; Dentistry; Facial Bones - surgery; Fiducial Markers; Frontal Bone - surgery; Humans; Image Processing, Computer-Assisted - methods; Image-guided surgery; Imaging, Three-Dimensional - methods; Intraoperative navigation; Maxilla - surgery; Models, Anatomic; Orbit - surgery; Osteotomy - instrumentation; Osteotomy - methods; Patient Care Planning; Surgery; Surgery, Computer-Assisted - instrumentation; Surgery, Computer-Assisted - methods; Treatment Outcome; User-Computer Interface; Virtual surgical planning; Virtual surgical planning; Image-guided surgery; Craniomaxillofacial resection; Intraoperative navigation; Computer-assisted surgery; Bone-cutting templates
• ISSN: 1010-5182; 1878-4119
• DOI: 10.1016/j.jcms.2015.06.012

Abstract Objective To evaluate the accuracy of craniomaxillofacial resections performed with an image-guided surgical sagittal saw. Material and methods Twenty-four craniomaxillofacial resections were performed using an image-guided sagittal saw. Surgical outcomes were compared with a preoperative virtual plan in terms of the resected bone volume, control point position and osteotomy trajectory angle. Each measurement was performed twice by two independent observers. Results The best convergence between the planned and actual bone resection was observed for the orbital region (6.33 ± 4.04%). The smallest mean difference between the preoperative and postoperative control point positions (2.00 ± 0.66 mm) and the lowest mean angular deviation between the virtual and actual osteotomy (5.49 ± 3.17 degrees) were documented for the maxillary region. When all the performed procedures were analyzed together, mean difference between the planned and actual bone resection volumes was 9.48 ± 4.91%, mean difference between the preoperative and postoperative control point positions amounted to 2.59 ± 1.41 mm, and mean angular deviation between the planned and actual osteotomy trajectory equaled 8.21 ± 5.69 degrees. Conclusion The results of this study are encouraging but not fully satisfactory. If further improved, the hereby presented navigation technique may become a valuable supporting method for craniomaxillofacial resections.