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Published in: International Journal of Computer Assisted Radiology and Surgery 12/2017

01-12-2017 | Review Article

Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning

Authors: Peng Yuan, Huaming Mai, Jianfu Li, Dennis Chun-Yu Ho, Yingying Lai, Siting Liu, Daeseung Kim, Zixiang Xiong, David M. Alfi, John F. Teichgraeber, Jaime Gateno, James J. Xia

Published in: International Journal of Computer Assisted Radiology and Surgery | Issue 12/2017

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Abstract

Purpose

There are many proven problems associated with traditional surgical planning methods for orthognathic surgery. To address these problems, we developed a computer-aided surgical simulation (CASS) system, the AnatomicAligner, to plan orthognathic surgery following our streamlined clinical protocol.

Methods

The system includes six modules: image segmentation and three-dimensional (3D) reconstruction, registration and reorientation of models to neutral head posture, 3D cephalometric analysis, virtual osteotomy, surgical simulation, and surgical splint generation. The accuracy of the system was validated in a stepwise fashion: first to evaluate the accuracy of AnatomicAligner using 30 sets of patient data, then to evaluate the fitting of splints generated by AnatomicAligner using 10 sets of patient data. The industrial gold standard system, Mimics, was used as the reference.

Result

When comparing the results of segmentation, virtual osteotomy and transformation achieved with AnatomicAligner to the ones achieved with Mimics, the absolute deviation between the two systems was clinically insignificant. The average surface deviation between the two models after 3D model reconstruction in AnatomicAligner and Mimics was 0.3 mm with a standard deviation (SD) of 0.03 mm. All the average surface deviations between the two models after virtual osteotomy and transformations were smaller than 0.01 mm with a SD of 0.01 mm. In addition, the fitting of splints generated by AnatomicAligner was at least as good as the ones generated by Mimics.

Conclusion

We successfully developed a CASS system, the AnatomicAligner, for planning orthognathic surgery following the streamlined planning protocol. The system has been proven accurate. AnatomicAligner will soon be available freely to the boarder clinical and research communities.
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Metadata
Title
Design, development and clinical validation of computer-aided surgical simulation system for streamlined orthognathic surgical planning
Authors
Peng Yuan
Huaming Mai
Jianfu Li
Dennis Chun-Yu Ho
Yingying Lai
Siting Liu
Daeseung Kim
Zixiang Xiong
David M. Alfi
John F. Teichgraeber
Jaime Gateno
James J. Xia
Publication date
01-12-2017
Publisher
Springer International Publishing
Published in
International Journal of Computer Assisted Radiology and Surgery / Issue 12/2017
Print ISSN: 1861-6410
Electronic ISSN: 1861-6429
DOI
https://doi.org/10.1007/s11548-017-1585-6

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