Accuracy and reproducibility of virtual cutting guides and 3D-navigation for osteotomies of the mandible and maxilla.

Accuracy and reproducibility of virtual cutting guides and 3D-navigation for osteotomies of the mandible and maxilla.

PLoS One. 2017;12(3):e0173111

Authors: Bernstein JM, Daly MJ, Chan H, Qiu J, Goldstein D, Muhanna N, de Almeida JR, Irish JC

Abstract
BACKGROUND: We set out to determine the accuracy of 3D-navigated mandibular and maxillary osteotomies with the ultimate aim to integrate virtual cutting guides and 3D-navigation into ablative and reconstructive head and neck surgery.
METHODS: Four surgeons (two attending, two clinical fellows) completed 224 unnavigated and 224 3D-navigated osteotomies on anatomical models according to preoperative 3D plans. The osteotomized bones were scanned and analyzed.
RESULTS: Median distance from the virtual plan was 2.1 mm unnavigated (IQR 2.6 mm, ≥3 mm in 33%) and 1.2 mm 3D-navigated (IQR 1.1 mm, ≥3 mm in 6%) (P<0.0001); median pitch was 4.5° unnavigated (IQR 7.1°) and 3.5° 3D-navigated (IQR 4.0°) (P<0.0001); median roll was 7.4° unnavigated (IQR 8.5°) and 2.6° 3D-navigated (IQR 3.8°) (P<0.0001).
CONCLUSION: 3D-rendering enables osteotomy navigation. 3 mm is an appropriate planning distance. The next steps are translating virtual cutting guides to free bone flap reconstruction and clinical use.

PMID: 28249001 [PubMed - in process]

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