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Precise screw positioning at the mandibular angle: computer assisted versus template coded


Lübbers, H T; Kruse, A; Messmer, P; Grätz, K W; Obwegeser, J A; Matthews, F (2011). Precise screw positioning at the mandibular angle: computer assisted versus template coded. Journal of Craniofacial Surgery, 22(2):620-624.

Abstract

BACKGROUND:

Buried intraoral devices for distraction osteogenesis in mandibular deformities have numerous advantages, but success depends on the precise positioning of these devices. Although most centers nowadays use template-guided techniques for precise positioning, computer navigation has been described as a promising technique. Surgical navigation during device placement could become a viable method because it affords certainty in defining a device position.
METHODS:

A clinical situation was simulated by means of mounting a mandible model inside a phantom head. Screws were positioned according to a preoperative plan through transoral and transbuccal approaches, with both template-coded and freehand computer navigation.
RESULTS:

With template-coded navigation, the medium deviation from the planned position was 0.63 mm (range, 0.00-1.24 mm). With commercial freehand surgical computer navigation, the medium deviation was significantly higher at 0.98 mm (range, 0.00-3.13 mm).
CONCLUSIONS:

Computer-assisted surgery can provide a high level of accuracy in the region of the mandibular angle where precision is crucial for buried intraoral distraction devices. However, template-coded guidance does provide a significantly higher level of accuracy and therefore represents the gold standard.

BACKGROUND:

Buried intraoral devices for distraction osteogenesis in mandibular deformities have numerous advantages, but success depends on the precise positioning of these devices. Although most centers nowadays use template-guided techniques for precise positioning, computer navigation has been described as a promising technique. Surgical navigation during device placement could become a viable method because it affords certainty in defining a device position.
METHODS:

A clinical situation was simulated by means of mounting a mandible model inside a phantom head. Screws were positioned according to a preoperative plan through transoral and transbuccal approaches, with both template-coded and freehand computer navigation.
RESULTS:

With template-coded navigation, the medium deviation from the planned position was 0.63 mm (range, 0.00-1.24 mm). With commercial freehand surgical computer navigation, the medium deviation was significantly higher at 0.98 mm (range, 0.00-3.13 mm).
CONCLUSIONS:

Computer-assisted surgery can provide a high level of accuracy in the region of the mandibular angle where precision is crucial for buried intraoral distraction devices. However, template-coded guidance does provide a significantly higher level of accuracy and therefore represents the gold standard.

Citations

5 citations in Web of Science®
7 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Dental Medicine > Clinic for Cranio-Maxillofacial Surgery
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2011
Deposited On:22 Feb 2012 12:31
Last Modified:05 Apr 2016 15:40
Publisher:Lippincott Wiliams & Wilkins
ISSN:1049-2275
Additional Information:This is a non-final version of an article published in final form in Lübbers, H T; Kruse, A; Messmer, P; Grätz, K W; Obwegeser, J A; Matthews, F (2011). Precise screw positioning at the mandibular angle: computer assisted versus template coded. Journal of Craniofacial Surgery, 22(2):620-624.
Publisher DOI:https://doi.org/10.1097/SCS.0b013e3182085519
PubMed ID:21403542
Permanent URL: https://doi.org/10.5167/uzh-60002

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