Virtual planning and intraoperative control using computer navigation systems in orthognatic surgery

Mitroshenkov P.P.; Drobyshev A.Y.; Mitroshenkov P.N.; Mikhaylyukov V.M.

doi:https://doi.org/10.17116/stomat20209905138

Mitroshenkov P.P.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
Clinical hospital N1 of the Russian President Administration

Drobyshev A.Y.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Mitroshenkov P.N.

Clinical hospital N1 of the Russian President Administration

Mikhaylyukov V.M.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Virtual planning and intraoperative control using computer navigation systems in orthognatic surgery

Authors:

Mitroshenkov P.P., Drobyshev A.Y., Mitroshenkov P.N., Mikhaylyukov V.M.

More about the authors

Journal: Stomatology. 2020;99(5): 38‑45

DOI: 10.17116/stomat20209905138

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To cite this article:

Mitroshenkov PP, Drobyshev AY, Mitroshenkov PN, Mikhaylyukov VM. Virtual planning and intraoperative control using computer navigation systems in orthognatic surgery. Stomatology. 2020;99(5):38‑45. (In Russ.)
https://doi.org/10.17116/stomat20209905138

Подписка 2026 Стоматология (Stomatology)

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THE AIM

To evaluate versality and accuracy of computer navigation in orthognathic surgery, analyzing the position of osteotomized bone fragments on virtual and postoperative 3D models.

MATERIAL AND METHODS

During our study we operated 27 patients with different asymmetric deformations of facial skeleton (13 patients with Class III Angle, 11 patients with Class II Angle and 3 patients with hemifacial microsomia). In 7 clinical cases optical navigation stations BrainLab 18070 Kick («BrainLab», Germany) and Stryker CranialMap CMF Version 2.0 («Stryker», USA) were used for preoperative virtual planning. In other clinical cases (20 patients) preoperative planning performed with using of 3D-cephafolometric programs Dolphin Imagin» and Blender 2.79. Intraoperative control of osteotomized bone fragments performed with using of optical navigation stations BrainLab 18070 Kick («BrainLab», Germany) and Stryker CranialMap CMF Version 2.0 («Stryker», USA).

RESULTS

Mean surgical time was 181 minutes (150—210 min). Mean time of registration procedure was 5 minutes (3—8 min). Mean target registration error (TRE) was 0.9±0.18 mm. Absolute difference values between actual and virtual movements of maxilla was from 0.72 to 1.12 mm in vertical, from 0.56 to 0.94 mm in sagittal (COP) and from 0.39 to 0.58 mm in transversal (MSP) planes.

CONCLUSION

Intraoperative control of maxilla-mandibular complex with using of computer navigation in orthognathic surgery allows to simplify bone fragments positioning, reduce surgery time, obtain a satisfactory aesthetic treatment result with occlusion restoration.

Keywords:

asymmetric deformation

computer navigation

3D-cephalometry

virtual orthognatic planning

optical navigation system

Authors:

Mitroshenkov P.P.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov;
Clinical hospital N1 of the Russian President Administration

Drobyshev A.Y.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Mitroshenkov P.N.

Clinical hospital N1 of the Russian President Administration

Mikhaylyukov V.M.

Moscow State University of Medicine and Dentistry named after A.I. Evdokimov

Received:

24.06.2019

Accepted:

03.02.2020

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References:

Bell RB. Computer Planning and Intraoperative Navigation in Cranio-maxillofacial Surgery. Oral Maxillofac Surg Clin North Am. 2010;22(1):135-156. https://doi.org/10.1016/j.coms.2009.10.010
Chang H-W, Lin H-H, Chortrakarnkij P, Kim SG. Intraoperative navigation for single-splint two-jaw orthognathic surgery: From model to actual surgery. J Craniomaxillofac Surg. 2015;43(7):1119-1126. https://doi.org/10.1016/j.jcms.2015.06.009
Sun Y, Luebbers H-T, Agbaje JO, Lambrichts I, Politis C. The Accuracy of Image-Guided Navigation for Maxillary Positioning in Bimaxillary Surgery. J Craniofac Surg. 2014;25(3):1095-1099. https://doi.org/10.1097/scs.0000000000000633
Chang HW, Lin HH, Chortrakarnkij P, Kim SG, Lo LJ. Intraoperative navigation for single-splint two-jaw orthognathic surgery: From model to actual surgery. J Craniomaxillofac Surg. 2015;43(7):1119-1126. https://doi.org/10.1016/j.jcms.2015.06.009
Lin H-H, Chang H-W, Wang C-H, Kim SG, Lo LJ. Three-Dimensional Computer-Assisted Orthognathic Surgery. J Ann Plastic Surg. 2015;74:118-126. https://doi.org/10.1097/sap.0000000000000455
Max J, Zinser MJ, Mischkowski RA, Dreiseidler T, Thamm OC, Rothamel D, Zöller JE. Computer-assisted orthognathic surgery: waferless maxillary positioning, versatility, and accuracy of an image-guided visualisation display. Br J Oral Maxillofac Surg. 2013;51(8):827-833. https://doi.org/10.1016/j.bjoms.2013.06.014
Schramm A, Gellrich N-C. Schmelzeisen R. Navigational Surgery of the Facial Skeleton. Berlin Heidelberg (NY): Springer; 2007.
Bobek Samuel L. Applications of Navigation for Orthognathic Surgery. Oral Maxillofacial Surg Clin North Am. 2014;26(4):587-598. https://doi.org/10.1016/j.coms.2014.08.003
Sun Y, Luebbers HT, Agbaje JO, Schepers S, Vrielinck L, Lambrichts I, Politis C. Validation of anatomical landmarks-based registration for image-guided surgery: an in-vitro study. J Craniomaxillofac Surg. 2013;41:522-526. https://doi.org/10.1016/j.jcms.2012.11.017
Lübbers HT, Medinger L, Kruse AL, Gratz KW, Obwegeser JA, Matthews F. The influence of involuntary facial movements on craniofacial anthropometry: a survey using a three-dimensional photographic system. Br J Oral Maxillofac Surg. 2012;50(2):171-175. https://doi.org/10.1016/j.bjoms.2010.12.002
Bempt M, Liebregts J, Maal T, Bergé S, Tong Xi. Toward a higher accuracy in orthognathic surgery by using intraoperative computer navigation, 3D surgical guides, and/or customized osteosynthesis plates: A systematic review. J Craniomaxillofac Surg. 2018;46(12):2108-2119. https://doi.org/10.1016/j.jcms.2018.10.012
Ehrenfeld M, Manson P, Prein J. Principles of Internal Fixation in the Cranio-Facial Skeleton. Trauma and Orthognatic Surgery. Springer; 2012.