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使用定制植入物进行重建时机器人引导激光截骨术的尺寸精度评估——数字高科技手术的精度研究

Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants-An Accuracy Study of Digital High-Tech Procedures.

作者信息

Msallem Bilal, Veronesi Lara, Beyer Michel, Halbeisen Florian S, Maintz Michaela, Franke Adrian, Korn Paula, Dragu Adrian, Thieringer Florian M

机构信息

University Center for Orthopedics, Trauma and Plastic Surgery, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, DE-01307 Dresden, Germany.

Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland.

出版信息

J Clin Med. 2024 Jun 19;13(12):3594. doi: 10.3390/jcm13123594.

Abstract

: With the rapid advancement in surgical technologies, new workflows for mandibular reconstruction are constantly being evaluated. Cutting guides are extensively employed for defining osteotomy planes but are prone to errors during fabrication and positioning. A virtually defined osteotomy plane and drilling holes in robotic surgery minimize potential sources of error and yield highly accurate outcomes. : Ten mandibular replicas were evaluated after cutting-guided saw osteotomy and robot-guided laser osteotomy following reconstruction with patient-specific implants. The descriptive data analysis summarizes the mean, standard deviation (SD), median, minimum, maximum, and root mean square (RMS) values of the surface comparison for 3D printed models regarding trueness and precision. : The saw group had a median trueness RMS value of 2.0 mm (SD ± 1.7) and a precision of 1.6 mm (SD ± 1.4). The laser group had a median trueness RMS value of 1.2 mm (SD ± 1.1) and an equal precision of 1.6 mm (SD ± 1.4). These results indicate that robot-guided laser osteotomies have a comparable accuracy to cutting-guided saw osteotomies, even though there was a lack of statistical significance. : Despite the limited sample size, this digital high-tech procedure has been shown to be potentially equivalent to the conventional osteotomy method. Robotic surgery and laser osteotomy offers enormous advantages, as they enable the seamless integration of precise virtual preoperative planning and exact execution in the human body, eliminating the need for surgical guides in the future.

摘要

随着手术技术的快速发展,下颌骨重建的新工作流程不断得到评估。切割导板被广泛用于确定截骨平面,但在制作和定位过程中容易出错。在机器人手术中,虚拟定义的截骨平面和钻孔可将潜在误差源降至最低,并产生高度精确的结果。

对10个下颌骨模型在使用患者特异性植入物重建后,进行切割导板锯截骨和机器人导板激光截骨后进行评估。描述性数据分析总结了3D打印模型在准确性和精度方面表面比较的平均值、标准差(SD)、中位数、最小值、最大值和均方根(RMS)值。

锯切组的准确性RMS中位数为2.0毫米(标准差±1.7),精度为1.6毫米(标准差±1.4)。激光组的准确性RMS中位数为1.2毫米(标准差±1.1),精度相同,为1.6毫米(标准差±1.4)。这些结果表明,机器人导板激光截骨术与切割导板锯截骨术具有相当的准确性,尽管缺乏统计学意义。

尽管样本量有限,但这种数字高科技手术已被证明可能等同于传统截骨方法。机器人手术和激光截骨术具有巨大优势,因为它们能够将精确的术前虚拟规划与人体中的精确执行无缝集成,未来无需手术导板。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0c95/11204867/7da28bb60202/jcm-13-03594-g001.jpg

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