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Zhang Z, Yang M, Zhang R. Radiographic grid for locating foreign bodies in maxillofacial emergency trauma. BMC Oral Health 2024; 24:46. [PMID: 38191426 PMCID: PMC10775646 DOI: 10.1186/s12903-023-03807-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 12/19/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVES The accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points. METHODS This work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model. RESULTS The study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients' FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05). CONCLUSIONS This study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.
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Affiliation(s)
- Ziqi Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Mingliang Yang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China
| | - Ran Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Liaoning Provincial Key Laboratory of Oral Diseases, China Medical University, Shenyang, 110002, China.
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Zhang J, Yu Y, Miao R, Ren J, Jiang Y, Jing W. Treatment effect analysis of curettage for jaw cysts based on volumetric assessment and image registration. J Craniomaxillofac Surg 2022; 50:S1010-5182(22)00132-9. [PMID: 36270886 DOI: 10.1016/j.jcms.2022.09.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/05/2022] [Accepted: 09/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study was conducted to develop a visual and intuitive quantitative evaluation method for maxillary cystic lesions after curettage. Mimics 16.0 and Geomagic Studio 2013 were used to form a precise reconstruction of the cystic lesion morphology of 60 cases; the average reduction rates and 95% confidence interval were calculated. Computed tomography (CT) registration was performed before and after surgery to observe morphology features of the bone regeneration of the cystic area. The average reduction rates (RR) of the cysts after curettage were (43.56 ± 16.79)%, (54.33 ± 17.15)% and (68.53 ± 15.99)% at 3 months, 6 months and 12 months after surgery, respectively. The average monthly reduction rates (MRR) were (12.07 ± 4.35)%, (8.16 ± 2.84)% and (5.35 ± 1.52)% at 3 months, 6 months and 12 months after surgery, respectively. Correlation analysis by comparing with each group showed that the effect of sex and age in the 3-month group and the initial size in the 12-month group on RR and MRR were statistically significant. Within the limitations of the study it seems that the chosen approach for quantitative evaluation of the therapeutic effect of curettage for jaw cystic lesions might facilitate visual and quantitative follow-up of cyst curettage and timely detection of recurrence.
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Affiliation(s)
- Jiankang Zhang
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Yunbo Yu
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Rong Miao
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Jiayin Ren
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral Radiology, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China
| | - Yichen Jiang
- Stomatological Hospital of Chongqing Medical University, Chongqing, 401147, China
| | - Wei Jing
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China School & Hospital of Stomatology, Sichuan University, No. 14, 3rd Section of Renmin South Road, Chengdu, 610041, China.
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Ren J, You M, Wang H, Tang B, Liu Y. A comparative evaluation of cone beam computed tomography and multi-slice computed tomography on the volume of tooth in-vitro. 2021 IEEE INTERNATIONAL CONFERENCE ON MEDICAL IMAGING PHYSICS AND ENGINEERING (ICMIPE) 2021. [DOI: 10.1109/icmipe53131.2021.9698963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Jiayin Ren
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Meng You
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Hu Wang
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Bei Tang
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
| | - Yuanyuan Liu
- National Clinical Research Center for Oral Diseases, Sichuan University,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology,Department of Oral Radiology,Chengdu,China
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Abolvardi M, Akhlaghian M, Hamidi Shishvan H, Dastan F. Detection of different foreign bodies in the maxillofacial region with spiral computed tomography and cone-beam computed tomography: An in vitro study. Imaging Sci Dent 2021; 50:291-298. [PMID: 33409137 PMCID: PMC7758271 DOI: 10.5624/isd.2020.50.4.291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose The detection and exact localization of penetrating foreign bodies are crucial for the appropriate management of patients with dentoalveolar trauma. This study compared the efficacy of cone-beam computed tomography (CBCT) and spiral computed tomography (CT) scans for the detection of different foreign bodies composed of 5 frequently encountered materials in 2 sizes. The effect of the location of the foreign bodies on their visibility was also analyzed. Materials and Methods In this in vitro study, metal, tooth, stone, glass, and plastic particles measuring 1×1×1 mm and 2×2×2 mm were prepared. They were implanted in a sheep's head in the tongue muscle, nasal cavity, and at the interface of the mandibular cortex and soft tissue. CBCT and spiral CT scans were taken and the visibility of foreign bodies was scored by 4 skilled maxillofacial radiologists who were blinded to the location and number of foreign bodies. Results CT and CBCT were equally accurate in visualizing metal, stone, and tooth particles of both sizes. However, CBCT was better for detecting glass particles in the periosteum. Although both imaging modalities visualized plastic particles poorly, CT was slightly better for detecting plastic particles, especially the smaller ones. Conclusion Considering the lower patient radiation dose and cost, CBCT can be used with almost equal accuracy as CT for detecting foreign bodies of different compositions and sizes in multiple maxillofacial regions. However, CT performed better for detecting plastic particles.
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Affiliation(s)
- Masoud Abolvardi
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Marzieh Akhlaghian
- Department of Prosthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Hamidi Shishvan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, AJA University of Medical Sciences, Tehran, Iran
| | - Farivar Dastan
- Department of Orthodontics, School of Dentistry, Shahed University, Tehran, Iran
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Yan ZY, Tan Y, Xie XY, He W, Guo CB, Cui NH. Computer-aided three-dimensional assessment of periodontal healing distal to the mandibular second molar after coronectomy of the mandibular third molar: a prospective study. BMC Oral Health 2020; 20:264. [PMID: 32972396 PMCID: PMC7513308 DOI: 10.1186/s12903-020-01250-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 09/09/2020] [Indexed: 01/19/2023] Open
Abstract
Background The periodontal healing distal to the mandibular second molar (M2M) after coronectomy of the M3M has shown controversial results. We aimed to combine a digital method with cone-beam computed tomography (CBCT) and estimate periodontal healing of M2M after M3M coronectomy. An accurate and stable indicator in three dimensions was also explored tentatively. Methods Patients with a M3M in contact with the inferior alveolar canal were included. CBCT was applied immediately after coronectomy (baseline) and 6-months later. Data were investigated with digital software for registration. Previously reported and coronectomy-related factors were included for univariate and multivariate analyses. Results A total of 181 patients (213 M3Ms) completed 6-month follow-up. Significant reduction in the distal intra-bony defect (DBD) depth of the M2M was shown (1.28 ± 1.24 mm, P < 0.001). DBD depth of the M2M at baseline was the most influential factor (r = 0.59), followed by preoperative M3M condition, age, rotation and migration of the root complex. Remaining enamel (OR = 6.93) and small retromolar space (0.67) contributed to re-contact of the root complex and M2M. Bone volume regenerated in the distal 2 mm was associated significantly with DBD-depth reduction (r = 0.74, P < 0.001). Conclusions Bone volume regenerated in the distal 2 mm of the M2M denoted stability of distal periodontal healing of the M2M. DBD depth at baseline was the most influential factor for healing of a DBD of the M2M after M3M coronectomy. The remaining enamel and a small retromolar space could contribute to re-contact of the root complex and the M2M. Trial registration China Clinical Trial Center, ChiCTR1800014862. Registered 10 February 2018,
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Affiliation(s)
- Z Y Yan
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Street Zhong Guan Cun, Haidian District, Beijing, 100081, China
| | - Y Tan
- Department of Medical Statistics, Peking University Clinical Research Institute, Beijing, China
| | - X Y Xie
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
| | - W He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Street Zhong Guan Cun, Haidian District, Beijing, 100081, China
| | - C B Guo
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Street Zhong Guan Cun, Haidian District, Beijing, 100081, China.
| | - N H Cui
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, 22 South Street Zhong Guan Cun, Haidian District, Beijing, 100081, China.
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Lee SJ, Yang HJ, Choi MH, Woo SY, Huh KH, Lee SS, Heo MS, Choi SC, Hwang SJ, Yi WJ. Real-time augmented model guidance for mandibular proximal segment repositioning in orthognathic surgery, using electromagnetic tracking. J Craniomaxillofac Surg 2018; 47:127-137. [PMID: 30447987 DOI: 10.1016/j.jcms.2018.10.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 09/17/2018] [Accepted: 10/18/2018] [Indexed: 10/28/2022] Open
Abstract
It is essential to reposition the mandibular proximal segment (MPS) as close to its original position as possible during orthognathic surgery. Conventional methods cannot pinpoint the exact position of the condyle in the fossa in real time during repositioning. In this study, based on an improved registration method and a separable electromagnetic tracking tool, we developed a real-time, augmented, model-guided method for MPS surgery to reposition the condyle into its original position more accurately. After virtual surgery planning, using a complex maxillomandibular model, the final position of the virtual MPS model was simulated via 3D rotations. The displacements resulting from the MPS simulation were applied to the MPS landmarks to indicate their final postoperative positions. We designed a new registration body with 24 fiducial points for registration, and determined the optimal point group on the registration body through a phantom study. The registration between the patient's CT image and physical spaces was performed preoperatively using the optimal points. We also developed a separable frame for installing the electromagnetic tracking tool on the patient's MPS. During MPS surgery, the electromagnetic tracking tool was repeatedly attached to, and separated from, the MPS using the separable frame. The MPS movement resulting from the surgeon's manipulation was tracked by the electromagnetic tracking system. The augmented condyle model and its landmarks were visualized continuously in real time with respect to the simulated model and landmarks. Our method also provides augmented 3D coronal and sagittal views of the fossa and condyle, to allow the surgeon to examine the 3D condyle-fossa positional relationship more accurately. The root mean square differences between the simulated and intraoperative MPS models, and between the simulated and postoperative CT models, were 1.71 ± 0.63 mm and 1.89 ± 0.22 mm respectively at three condylar landmarks. Thus, the surgeons could perform MPS repositioning conveniently and accurately based on real-time augmented model guidance on the 3D condyle positional relationship with respect to the glenoid fossa, using augmented and simulated models and landmarks.
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Affiliation(s)
- Sang-Jeong Lee
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Hoon Joo Yang
- Orthognathic Surgery Center (Head: Soon Jung Hwang, DDS, MD, PhD), Seoul National University Dental Hospital, South Korea
| | - Min-Hyuk Choi
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery (Head: Jin-Young Choi, DDS, MD, PhD), School of Dentistry, Dental Research Institute, BK21 Plus, Seoul National University, South Korea.
| | - Won-Jin Yi
- Department of Biomedical Radiation Sciences (Head: Sung-Joon Ye, PhD), Graduate School of Convergence Science and Technology, Seoul National University, South Korea; Department of Oral and Maxillofacial Radiology (Head: Min-Suk Heo, DDS, PhD), School of Dentistry and Dental Research Institute, Seoul National University, South Korea.
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Cottrell DA, Farrell B, Ferrer-Nuin L, Ratner S. Surgical Correction of Maxillofacial Skeletal Deformities. J Oral Maxillofac Surg 2017; 75:e94-e125. [DOI: 10.1016/j.joms.2017.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Walliczek-Dworschak U, Diogo I, Strack L, Mandapathil M, Teymoortash A, Werner J, Güldner C. Indications of cone beam CT in head and neck imaging in children. ACTA OTORHINOLARYNGOLOGICA ITALICA : ORGANO UFFICIALE DELLA SOCIETA ITALIANA DI OTORINOLARINGOLOGIA E CHIRURGIA CERVICO-FACCIALE 2017; 37:270-275. [PMID: 28872156 PMCID: PMC5584097 DOI: 10.14639/0392-100x-1219] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022]
Abstract
For imaging of bony structures, especially for the anterior and lateral skull base in ORL medicine, cone beam computed tomography (CBCT) is an increasingly used alternative to CT, with a lower exposition to plain radiography that makes its use for imaging, particularly in children, very interesting. The aim of this study was to analyse possible indications and settings for CBCT in children and compare them to those of adults. A total of 554 patients (age range 0-18 years, mean age 10.36 years), who underwent CBCT between 01/2004-06/2013 in the ENT department at the university clinic of Marburg were enrolled in this retrospective analysis to evaluate technical parameters and indications. Data on CBCT of all children were compared with previously published data collected from 1730 adults who were diagnosed with the help of CBCT in the ENT department at the university clinic of Marburg, during the years 2012-2013. The most frequent indications of CBCT in children vs. adults were in the anterior skull base region: mid-facial trauma (60.4%) vs. chronic rhinosinusitis (54.8%), disturbed nasal breathing (13.9% vs. 13.0%) and chronic rhinosinusitis (12%) vs. mid-facial trauma (10.8%). For the lateral skull base the main indications were cholesteatoma (20.3%) vs. position control of cochlear implant (CI) electrode (31.2%), chronic otorrhoea (17.5%) vs. cholesteatoma (20.9%), and position control of CI electrode (11.8%) vs. chronic otitis media mesotympanalis (6.8%). CBCT is a suitable imaging modality for bony structures in adults and children. Settings mainly depend on the region of interest. One aim should also be to reduce exposure to radiation in both adults and children.
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Affiliation(s)
| | | | | | | | | | | | - C. Güldner
- Department of ORL, Head and Neck Surgery, UKGM, Marburg, Germany
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Sang YH, Hu HC, Lu SH, Wu YW, Li WR, Tang ZH. Accuracy Assessment of Three-dimensional Surface Reconstructions of In vivo Teeth from Cone-beam Computed Tomography. Chin Med J (Engl) 2017; 129:1464-70. [PMID: 27270544 PMCID: PMC4910372 DOI: 10.4103/0366-6999.183430] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: The accuracy of three-dimensional (3D) reconstructions from cone-beam computed tomography (CBCT) has been particularly important in dentistry, which will affect the effectiveness of diagnosis, treatment plan, and outcome in clinical practice. The aims of this study were to assess the linear, volumetric, and geometric accuracy of 3D reconstructions from CBCT and to investigate the influence of voxel size and CBCT system on the reconstructions results. Methods: Fifty teeth from 18 orthodontic patients were assigned to three groups as NewTom VG 0.15 mm group (NewTom VG; voxel size: 0.15 mm; n = 17), NewTom VG 0.30 mm group (NewTom VG; voxel size: 0.30 mm; n = 16), and VATECH DCTPRO 0.30 mm group (VATECH DCTPRO; voxel size: 0.30 mm; n = 17). The 3D reconstruction models of the teeth were segmented from CBCT data manually using Mimics 18.0 (Materialise Dental, Leuven, Belgium), and the extracted teeth were scanned by 3Shape optical scanner (3Shape A/S, Denmark). Linear and volumetric deviations were separately assessed by comparing the length and volume of the 3D reconstruction model with physical measurement by paired t-test. Geometric deviations were assessed by the root mean square value of the imposed 3D reconstruction and optical models by one-sample t-test. To assess the influence of voxel size and CBCT system on 3D reconstruction, analysis of variance (ANOVA) was used (α = 0.05). Results: The linear, volumetric, and geometric deviations were −0.03 ± 0.48 mm, −5.4 ± 2.8%, and 0.117 ± 0.018 mm for NewTom VG 0.15 mm group; −0.45 ± 0.42 mm, −4.5 ± 3.4%, and 0.116 ± 0.014 mm for NewTom VG 0.30 mm group; and −0.93 ± 0.40 mm, −4.8 ± 5.1%, and 0.194 ± 0.117 mm for VATECH DCTPRO 0.30 mm group, respectively. There were statistically significant differences between groups in terms of linear measurement (P < 0.001), but no significant difference in terms of volumetric measurement (P = 0.774). No statistically significant difference were found on geometric measurement between NewTom VG 0.15 mm and NewTom VG 0.30 mm groups (P = 0.999) while a significant difference was found between VATECH DCTPRO 0.30 mm and NewTom VG 0.30 mm groups (P = 0.006). Conclusions: The 3D reconstruction from CBCT data can achieve a high linear, volumetric, and geometric accuracy. Increasing voxel resolution from 0.30 to 0.15 mm does not result in increased accuracy of 3D tooth reconstruction while different systems can affect the accuracy.
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Affiliation(s)
- Yan-Hui Sang
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101; Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Hong-Cheng Hu
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101; National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Song-He Lu
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101; National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Yu-Wei Wu
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101; National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Wei-Ran Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Zhi-Hui Tang
- Second Dental Center, Peking University School and Hospital of Stomatology, Beijing 100101; National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University School and Hospital of Stomatology, Beijing 100081, China
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Lee SJ, Woo SY, Huh KH, Lee SS, Heo MS, Choi SC, Han JJ, Yang HJ, Hwang SJ, Yi WJ. Virtual skeletal complex model- and landmark-guided orthognathic surgery system. J Craniomaxillofac Surg 2016; 44:557-68. [PMID: 27012762 DOI: 10.1016/j.jcms.2016.02.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 01/30/2016] [Accepted: 02/19/2016] [Indexed: 11/26/2022] Open
Abstract
In this study, correction of the maxillofacial deformities was performed by repositioning bone segments to an appropriate location according to the preoperative planning in orthognathic surgery. The surgery was planned using the patient's virtual skeletal models fused with optically scanned three-dimensional dentition. The virtual maxillomandibular complex (MMC) model of the patient's final occlusal relationship was generated by fusion of the maxillary and mandibular models with scanned occlusion. The final position of the MMC was simulated preoperatively by planning and was used as a goal model for guidance. During surgery, the intraoperative registration was finished immediately using only software processing. For accurate repositioning, the intraoperative MMC model was visualized on the monitor with respect to the simulated MMC model, and the intraoperative positions of multiple landmarks were also visualized on the MMC surface model. The deviation errors between the intraoperative and the final positions of each landmark were visualized quantitatively. As a result, the surgeon could easily recognize the three-dimensional deviation of the intraoperative MMC state from the final goal model without manually applying a pointing tool, and could also quickly determine the amount and direction of further MMC movements needed to reach the goal position. The surgeon could also perform various osteotomies and remove bone interference conveniently, as the maxillary tracking tool could be separated from the MMC. The root mean square (RMS) difference between the preoperative planning and the intraoperative guidance was 1.16 ± 0.34 mm immediately after repositioning. After surgery, the RMS differences between the planning and the postoperative computed tomographic model were 1.31 ± 0.28 mm and 1.74 ± 0.73 mm for the maxillary and mandibular landmarks, respectively. Our method provides accurate and flexible guidance for bimaxillary orthognathic surgery based on intraoperative visualization and quantification of deviations for simulated postoperative MMC and landmarks. The guidance using simulated skeletal models and landmarks can complement and improve conventional navigational surgery for bone repositioning in the craniomaxillofacial area.
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Affiliation(s)
- Sang-Jeong Lee
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Sang-Yoon Woo
- Department of Biomedical Radiation Sciences, Graduate School of Convergence Science and Technology, Seoul National University, Seoul, South Korea
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Sam-Sun Lee
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Soon-Chul Choi
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Jeong Joon Han
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Hoon Joo Yang
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea
| | - Soon Jung Hwang
- Department of Oral and Maxillofacial Surgery, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
| | - Won-Jin Yi
- Department of Oral and Maxillofacial Radiology, BK21, Dental Research Institute, School of Dentistry, Seoul National University, Seoul, South Korea.
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Sun Y, Luebbers HT, Agbaje JO, Schepers S, Vrielinck L, Lambrichts I, Politis C. Evaluation of 3 different registration techniques in image-guided bimaxillary surgery. J Craniofac Surg 2015; 24:1095-9. [PMID: 23851747 DOI: 10.1097/scs.0b013e31828b6dea] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Perioperative navigation is an upcoming tool in orthognathic surgery. This study aimed to access the feasibility of the technique and to evaluate the success rate of 3 different registration methods--facial surface registration, anatomic landmark-based registration, and template-based registration. The BrainLab navigation system (BrainLab AG, Feldkirchen, Germany) was used as an additional precision tool for 85 patients who underwent bimaxillary orthognathic surgery from February 2010 to June 2012. Eighteen cases of facial surface-based registration, 63 cases of anatomic landmark-based registration, and 8 cases of template-based registration were analyzed. The overall success rate of facial surface-based registration was 39%, which was significant lower than template-based (100%, P = 0.013) and anatomic landmark-based registration (95%, P < 0.0001). In all cases with successful registration, the further procedure of surgical navigation was performed. The concept of navigation of the maxilla during bimaxillary orthognathic surgery has been proved to be feasible. The registration process is the critical point regarding success of intraoperative navigation. Anatomic landmark-based registration is a reliable technique for image-guided bimaxillary surgery. In contrast, facial surface-based registration is highly unreliable.
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Affiliation(s)
- Yi Sun
- Oral and Maxillofacial Surgery, St John's Hospital, Genk, Belgium
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Pierrefeu A, Terzic A, Volz A, Courvoisier D, Scolozzi P. How Accurate Is the Treatment of Midfacial Fractures by a Specific Navigation System Integrating “Mirroring” Computational Planning? Beyond Mere Average Difference Analysis. J Oral Maxillofac Surg 2015; 73:315.e1-315.e10. [DOI: 10.1016/j.joms.2014.09.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 09/05/2014] [Accepted: 09/29/2014] [Indexed: 11/16/2022]
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Dérand P, Rännar LE, Hirsch JM. Imaging, virtual planning, design, and production of patient-specific implants and clinical validation in craniomaxillofacial surgery. Craniomaxillofac Trauma Reconstr 2013; 5:137-44. [PMID: 23997858 DOI: 10.1055/s-0032-1313357] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2011] [Accepted: 11/15/2011] [Indexed: 10/28/2022] Open
Abstract
The purpose of this article was to describe the workflow from imaging, via virtual design, to manufacturing of patient-specific titanium reconstruction plates, cutting guide and mesh, and its utility in connection with surgical treatment of acquired bone defects in the mandible using additive manufacturing by electron beam melting (EBM). Based on computed tomography scans, polygon skulls were created. Following that virtual treatment plans entailing free microvascular transfer of fibula flaps using patient-specific reconstruction plates, mesh, and cutting guides were designed. The design was based on the specification of a Compact UniLOCK 2.4 Large (Synthes(®), Switzerland). The obtained polygon plates were bent virtually round the reconstructed mandibles. Next, the resections of the mandibles were planned virtually. A cutting guide was outlined to facilitate resection, as well as plates and titanium mesh for insertion of bone or bone substitutes. Polygon plates and meshes were converted to stereolithography format and used in the software Magics for preparation of input files for the successive step, additive manufacturing. EBM was used to manufacture the customized implants in a biocompatible titanium grade, Ti6Al4V ELI. The implants and the cutting guide were cleaned and sterilized, then transferred to the operating theater, and applied during surgery. Commercially available software programs are sufficient in order to virtually plan for production of patient-specific implants. Furthermore, EBM-produced implants are fully usable under clinical conditions in reconstruction of acquired defects in the mandible. A good compliance between the treatment plan and the fit was demonstrated during operation. Within the constraints of this article, the authors describe a workflow for production of patient-specific implants, using EBM manufacturing. Titanium cutting guides, reconstruction plates for fixation of microvascular transfer of osteomyocutaneous bone grafts, and mesh to replace resected bone that can function as a carrier for bone or bone substitutes were designed and tested during reconstructive maxillofacial surgery. A clinically fit, well within the requirements for what is needed and obtained using traditional free hand bending of commercially available devices, or even higher precision, was demonstrated in ablative surgery in four patients.
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Affiliation(s)
- Per Dérand
- Department of Oral and Maxillofacial Surgery, Lund University, Lund, Sweden
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Cottrell DA, Edwards SP, Gotcher JE. Surgical correction of maxillofacial skeletal deformities. J Oral Maxillofac Surg 2013; 70:e107-36. [PMID: 23127998 DOI: 10.1016/j.joms.2012.07.033] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Validation of anatomical landmarks-based registration for image-guided surgery: an in-vitro study. J Craniomaxillofac Surg 2012; 41:522-6. [PMID: 23273492 DOI: 10.1016/j.jcms.2012.11.017] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2012] [Revised: 11/13/2012] [Accepted: 11/14/2012] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Perioperative navigation is a recent addition to orthognathic surgery. This study aimed to evaluate the accuracy of anatomical landmarks-based registration. MATERIALS AND METHODS Eighty-five holes (1.2 mm diameter) were drilled in the surface of a plastic skull model, which was then scanned using a SkyView cone beam computed tomography scanner. DICOM files were imported into BrainLab ENT 3.0.0 to make a surgical plan. Six anatomical points were selected for registration: the infraorbital foramena, the anterior nasal spine, the crown tips of the upper canines, and the mesial contact point of the upper incisors. Each registration was performed five times by two separate observers (10 times total). RESULTS The mean target registration error (TRE) in the anterior maxillary/zygomatic region was 0.93 ± 0.31 mm (p < 0.001 compared with other anatomical regions). The only statistically significant inter-observer difference of mean TRE was at the zygomatic arch, but was not clinically relevant. CONCLUSION With six anatomical landmarks used, the mean TRE was clinically acceptable in the maxillary/zygomatic region. This registration technique may be used to access occlusal changes during bimaxillary surgery, but should be used with caution in other anatomical regions of the skull because of the large TRE observed.
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Widmann G, Zangerl A, Schullian P, Fasser M, Puelacher W, Bale R. Do Image Modality and Registration Method Influence the Accuracy of Craniofacial Navigation? J Oral Maxillofac Surg 2012; 70:2165-73. [DOI: 10.1016/j.joms.2011.08.026] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Revised: 08/13/2011] [Accepted: 08/15/2011] [Indexed: 11/25/2022]
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Brennan PA, Habib A. What are we reading? A study of downloaded and cited articles from the British Journal of Oral and Maxillofacial Surgery in 2010. Br J Oral Maxillofac Surg 2012; 49:527-31. [PMID: 21689872 DOI: 10.1016/j.bjoms.2011.05.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Accepted: 05/18/2011] [Indexed: 12/19/2022]
Abstract
A large number of papers related to oral and maxillofacial surgery are published in many specialist journals. With the ever-increasing use of the internet it is easy to download them as part of a journal subscription on a fee per paper basis, or in some cases for free. Online access to the British Journal of Oral and Maxillofacial Surgery (BJOMS) is free to British Association (BAOMS) members with a $30 fee per paper download for non-members. Many colleagues use the online version of the journal, and this provides valuable information about downloading trends. Other data on articles that have been cited in subsequent publications are also readily available, and they form the basis for the calculation of a journal's impact factor. We evaluated the top 50 downloaded papers from the BJOMS website in 2010 to ascertain which articles were being read online. We also obtained data on the number of citations for papers published in 2009-2010 to see whether these papers were similar to the articles being downloaded. In 2010 there were over 360000 downloaded articles. The most popular papers were leading articles, reviews, and full length articles; only one short communication featured in the top 50 downloads. The papers most cited in subsequent publications were full length articles and leading articles or reviews, which represent 80% of the total citations of the 50 papers. Ten papers were in both the top 50 downloaded and most cited lists. We discuss the implications of this study for the journal and our readers.
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Affiliation(s)
- Peter A Brennan
- Maxillofacial Unit, Queen Alexandra Hospital, Portsmouth PO6 3LY, UK.
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Lübbers HT, Matthews F, Zemann W, Grätz KW, Obwegeser JA, Bredell M. Registration for computer-navigated surgery in edentulous patients: A problem-based decision concept. J Craniomaxillofac Surg 2011; 39:453-8. [DOI: 10.1016/j.jcms.2010.10.021] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2010] [Revised: 10/06/2010] [Accepted: 10/19/2010] [Indexed: 10/18/2022] Open
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A Simple and Flexible Concept for Computer-Navigated Surgery of the Mandible. J Oral Maxillofac Surg 2011; 69:924-30. [DOI: 10.1016/j.joms.2010.01.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2009] [Accepted: 01/12/2010] [Indexed: 11/19/2022]
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The role of cone-beam computed tomography in the planning and placement of implants. J Am Dent Assoc 2011; 141 Suppl 3:19S-24S. [PMID: 20884936 DOI: 10.14219/jada.archive.2010.0358] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Three-dimensional imaging, particularly cone-beam computed tomography (CBCT), has made significant contributions to the planning and placement of implants to replace missing teeth. The accuracy of CBCT data can be used to fabricate a surgical guide that transfers the implant planning information to the surgical site to facilitate implant placement. The authors describe a method for applying CBCT data to aid in the planning and placement of implants. METHODS The authors outline clinical goals for implant planning and placement and describe the anatomical and prosthetic requirements for successful implant placement. They also present imaging solutions, including CBCT scanning and software analysis, to the clinical goals. CONCLUSIONS Virtual implant planning using CBCT data allows the clinicians to create and visualize the end result before initiating treatment. CBCT scans are accurate and cost effective and can be used to improve communication and coordination of a multidisciplinary team to achieve the desired clinical outcome. Virtual planning allows clinicians to investigate multiple treatment scenarios until the optimum treatment plan is attained. The optimized virtual plan may be converted through modeling to create a surgical guide for clinical implementation. CLINICAL IMPLICATIONS The precise planning and delivery of implants to replace missing teeth can avert recognized and concealed treatment problems. This process aids the clinician and benefits the patient.
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Lübbers HT, Jacobsen C, Matthews F, Grätz KW, Kruse A, Obwegeser JA. Surgical Navigation in Craniomaxillofacial Surgery: Expensive Toy or Useful Tool? A Classification of Different Indications. J Oral Maxillofac Surg 2011; 69:300-8. [DOI: 10.1016/j.joms.2010.07.016] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 05/27/2010] [Accepted: 07/01/2010] [Indexed: 10/18/2022]
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Campbell PD, Zinreich SJ, Aygun N. Imaging of the paranasal sinuses and in-office CT. Otolaryngol Clin North Am 2010; 42:753-64, vii. [PMID: 19909856 DOI: 10.1016/j.otc.2009.08.015] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Since the introduction of functional endoscopic sinus surgery (FESS) in the United States in 1985, the information gained from imaging has proved imperative in understanding regional morphology and guidance of surgical procedures. More than 20 years later, the importance of imaging continues to be the anatomic detail afforded by this technology, the roadmap it provides in planning the surgery, and the morphologic detail it provides in recurrent disease. The latest development in CT technology, cone beam CT instrumentation, may change the way imaging of the nasal cavity and paranasal sinuses is performed in the future. These topics are discussed in this article.
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Affiliation(s)
- Paul D Campbell
- The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Medical Institutions, 600 North Wolfe Street/Phipps B-112, Baltimore, MD 21287, USA
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