J Korean Assoc Oral Maxillofac Surg.  2011 Apr;37(2):114-121. 10.5125/jkaoms.2011.37.2.114.

Accuracy of simulation surgery of Le Fort I osteotomy using optoelectronic tracking navigation system

• Bu YJ
• Kim SM
• Kim JY
• Park JM
• Myoung H
• Lee JH
• Kim MJ

• KMID: 2137000
• DOI: http://doi.org/10.5125/jkaoms.2011.37.2.114

Abstract

INTRODUCTION
The aim of this study was to demonstrate that the simulation surgery on rapid prototype (RP) model, which is based on the 3-dimensional computed tomography (3D CT) data taken before surgery, has the same accuracy as traditional orthograthic surgery with an intermediate splint, using an optoelectronic tracking navigation system.
MATERIALS AND METHODS
Simulation surgery with the same treatment plan as the Le Fort I osteotomy on the patient was done on a RP model based on the 3D CT data of 12 patients who had undergone a Le Fort I osteotomy in the department of oral and maxillofacial surgery, Seoul National University Dental Hospital. The 12 distances between 4 points on the skull, such as both infraorbital foramen and both supraorbital foramen, and 3 points on maxilla, such as the contact point of both maxillary central incisors and mesiobuccal cuspal tip of both maxillary first molars, were tracked using an optoelectronic tracking navigation system. The distances before surgery were compared to evaluate the accuracy of the RP model and the distance changes of 3D CT image after surgery were compared with those of the RP model after simulation surgery.
RESULTS
A paired t-test revealed a significant difference between the distances in the 3D CT image and RP model before surgery.(P<0.0001) On the other hand, Pearson's correlation coefficient, 0.995, revealed a significant positive correlation between the distances.(P<0.0001) There was a significant difference between the change in the distance of the 3D CT image and RP model in before and after surgery.(P<0.05) The Pearson's correlation coefficient was 0.13844, indicating positive correlation.(P<0.1)
CONCLUSION
Theses results suggest that the simulation surgery of a Le Fort I osteotomy using an optoelectronic tracking navigation system is relatively accurate in comparing the pre-, and post-operative 3D CT data. Furthermore, the application of an optoelectronic tracking navigation system may be a predictable and efficient method in Le Fort I orthognathic surgery.

Keyword

Optoelectronic tracking navigation system; Le Fort I osteotomy; Simulation surgery; Rapid prototype (RP) model

MeSH Terms

Hand
Humans
Incisor
Maxilla
Molar
Orthognathic Surgery
Osteotomy
Skull
Splints
Surgery, Oral
Track and Field

Figure

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  Fig. 1. Measuring the distance between 4 reference points and contact point of maxillary central incisors on a In2Vision 3-dimensional surgical navigation system.

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  Fig. 2. Used tools in this study. A was the computer system displaying In2Vision system, B was the registration probe, C was the navigation probe, D was the infrared VICRA Polaris camera.

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  Fig. 3. Preparation and measurement of rapid prototype model in this study. A. Microscrews were implanted in nasion, both supraorbital foramen, contact point of maxillary central incisors for the reproducible measurement. B. Gradation was drawn over the maxillary canine and first molar and SAS was implanted in mesiobuccal cusp tip of maxillary first molar. C. Measuring the vertical distance between left supraorbital foramen and mesiobuccal cusp tip of left maxillary first molar. (SAS: skeletal anchoring system)

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  Fig. 4. Tracking the points by using of In2Vision 3 dimensional surgical navigation system and Polaris Vicra tracking device.

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  Fig. 5. Measuring the distance between 4 reference points on skull and ICP after simulation surgery on RP model (ICP: interincisal contact point, RP: rapid prototyping)

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  Fig. 6. RMSE analysis graph of measured distances between 3D CT image in X axis and RP model in Y axis before surgery.(mm) (RMSE: root mean square error, 3D CT: 3 dimensional computed tomography, RP: rapid prototyping)

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  Fig. 7. RMSE analysis graph showing changes between before and after surgery in measured distances of 3D CT image in X axis and RP model in Y axis.(mm) (RMSE: root mean square error, 3D CT: 3 dimensional computed tomography, RP: rapid prototyping)

Reference

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