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用于简化正颌手术规划的计算机辅助手术模拟系统的设计、开发和临床验证。

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

机构信息

Department of Oral and Maxillofacial Surgery, Houston Methodist Research Institute, Houston, TX, 77030, USA.

Department of Electrical and Computer Engineering, Texas A&M University, College Station, TX, 77843, USA.

出版信息

Int J Comput Assist Radiol Surg. 2017 Dec;12(12):2129-2143. doi: 10.1007/s11548-017-1585-6. Epub 2017 Apr 21.


DOI:10.1007/s11548-017-1585-6
PMID:28432489
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5664166/
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.

摘要

目的:传统的正颌手术术前规划方法存在诸多已证实的问题。为了解决这些问题,我们开发了一种计算机辅助手术模拟(CASS)系统,即解剖配准器(AnatomicAligner),以遵循简化的临床方案来规划正颌手术。

方法:该系统包括六个模块:图像分割和三维(3D)重建、模型到中立头位的配准和重定向、3D 头影测量分析、虚拟截骨、手术模拟和手术夹板生成。系统的准确性是分步骤验证的:首先使用 30 组患者数据评估 AnatomicAligner 的准确性,然后使用 10 组患者数据评估 AnatomicAligner 生成的夹板的拟合度。使用 Mimics 作为工业金标准系统。

结果:当将 AnatomicAligner 实现的分割、虚拟截骨和转换结果与 Mimics 进行比较时,两个系统之间的绝对偏差在临床意义上无显著性差异。AnatomicAligner 和 Mimics 中 3D 模型重建后的两个模型之间的平均表面偏差为 0.3mm,标准差(SD)为 0.03mm。虚拟截骨和转换后两个模型之间的所有平均表面偏差均小于 0.01mm,SD 为 0.01mm。此外,AnatomicAligner 生成的夹板的拟合度至少与 Mimics 生成的夹板一样好。

结论:我们成功开发了一种用于简化规划方案的正颌手术计算机辅助手术模拟系统,即解剖配准器(AnatomicAligner)。该系统已被证明具有准确性。AnatomicAligner 很快将免费提供给更广泛的临床和研究社区。

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本文引用的文献

[1]
New approach to establish an object reference frame for dental arch in computer-aided surgical simulation.

Int J Oral Maxillofac Surg. 2017-9

[2]
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Med Eng Phys. 2016-11

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Comput Biol Med. 2016-8-1

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Int J Oral Maxillofac Surg. 2015-12

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Int J Oral Maxillofac Surg. 2015-12

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Ann Biomed Eng. 2016-5

[10]
Virtual surgical planning for orthognathic surgery using digital data transfer and an intraoral fiducial marker: the charlotte method.

J Oral Maxillofac Surg. 2015-6

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