Accuracy evaluation of CAD/CAM generated splints in orthognathic surgery: a cadaveric study
Identifieur interne : 000027 ( France/Analysis ); précédent : 000026; suivant : 000028Accuracy evaluation of CAD/CAM generated splints in orthognathic surgery: a cadaveric study
Auteurs : Thomas Schouman [France] ; Philippe Rouch [France] ; Benoît Imholz [Suisse] ; Jean Fasel [Suisse] ; Delphine Courvoisier [Suisse] ; Paolo Scolozzi [Suisse]Source :
- Head & Face Medicine [ 1746-160X ] ; 2015.
Abstract
To evaluate the accuracy of CAD/CAM generated splints in orthognathic surgery by comparing planned versus actual post-operative 3D images.
Specific planning software (SimPlant® OMS Standalone 14.0) was used to perform a 3D virtual Le Fort I osteotomy in 10 fresh human cadaver heads. Stereolithographic splints were then generated and used during the surgical procedure to reposition the maxilla according to the planned position. Pre-operative planned and postoperative 3D CT scan images were fused and imported to dedicated software (MATLAB®) 7.11.) for calculating the translational and rotational (pitch, roll and yaw) differences between the two 3D images. Geometrical accuracy was estimated using the Root Mean Square Deviations (RMSD) and lower and upper limits of accuracy were computed using the Bland & Altman method, with 95 % confidence intervals around the limits. The accuracy cutoff was set at +/− 2 mm for translational and ≤ 4° for rotational measurements.
Overall accuracy between the two 3D images was within the accuracy cutoff for all values except for the antero-posterior positioning of the maxilla (2.17 mm). The translational and rotational differences due to the splint were all within the accuracy cutoff. However, the width of the limits of agreement (range between lower and upper limits) showed that rotational differences could be particularly large.
This study demonstrated that maxillary repositioning can be accurately approximated and thus predicted by specific computational planning and CAD/CAM generated splints in orthognathic surgery. Further study should focus on the risk factors for inaccurate prediction.
Url:
DOI: 10.1186/s13005-015-0082-9
PubMed: 26209339
PubMed Central: 4514936
Affiliations:
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University of Geneva, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Anatomy, Faculty of Medicine - University of Geneva, Geneva</wicri:regionArea><orgName type="university">Université de Genève</orgName><placeName><settlement type="city">Genève</settlement><region nuts="3" type="region">Canton de Genève</region></placeName></affiliation></author><author><name sortKey="Courvoisier, Delphine" sort="Courvoisier, Delphine" uniqKey="Courvoisier D" first="Delphine" last="Courvoisier">Delphine Courvoisier</name><affiliation wicri:level="1"><nlm:aff id="Aff5">CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>CRC & Division of Clinical Epidemiology, Department of Health and Community Medicine, University of Geneva & University Hospitals of Geneva, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author><author><name sortKey="Scolozzi, Paolo" sort="Scolozzi, Paolo" uniqKey="Scolozzi P" first="Paolo" last="Scolozzi">Paolo Scolozzi</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Surgery, Service of Maxillofacial and Oral Surgery, University Hospital and Faculty of Medicine, Geneva, Switzerland</nlm:aff><country xml:lang="fr">Suisse</country><wicri:regionArea>Department of Surgery, Service of Maxillofacial and Oral Surgery, University Hospital and Faculty of Medicine, Geneva</wicri:regionArea><wicri:noRegion>Geneva</wicri:noRegion></affiliation></author></analytic><series><title level="j">Head & Face Medicine</title><idno type="eISSN">1746-160X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Introduction</title><p>To evaluate the accuracy of CAD/CAM generated splints in orthognathic surgery by comparing planned versus actual post-operative 3D images.</p></sec><sec><title>Methods</title><p>Specific planning software (SimPlant<sup>®</sup> OMS Standalone 14.0) was used to perform a 3D virtual Le Fort I osteotomy in 10 fresh human cadaver heads. Stereolithographic splints were then generated and used during the surgical procedure to reposition the maxilla according to the planned position. Pre-operative planned and postoperative 3D CT scan images were fused and imported to dedicated software (MATLAB<sup>®)</sup> 7.11.) for calculating the translational and rotational (pitch, roll and yaw) differences between the two 3D images. Geometrical accuracy was estimated using the Root Mean Square Deviations (RMSD) and lower and upper limits of accuracy were computed using the Bland & Altman method, with 95 % confidence intervals around the limits. The accuracy cutoff was set at +/− 2 mm for translational and ≤ 4° for rotational measurements.</p></sec><sec><title>Results</title><p>Overall accuracy between the two 3D images was within the accuracy cutoff for all values except for the antero-posterior positioning of the maxilla (2.17 mm). The translational and rotational differences due to the splint were all within the accuracy cutoff. However, the width of the limits of agreement (range between lower and upper limits) showed that rotational differences could be particularly large.</p></sec><sec><title>Conclusion</title><p>This study demonstrated that maxillary repositioning can be accurately approximated and thus predicted by specific computational planning and CAD/CAM generated splints in orthognathic surgery. Further study should focus on the risk factors for inaccurate prediction.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Olszewski, R" uniqKey="Olszewski R">R Olszewski</name></author><author><name sortKey="Reychler, H" uniqKey="Reychler H">H Reychler</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gil, Jn" uniqKey="Gil J">JN Gil</name></author><author><name sortKey="Claus, Jd" uniqKey="Claus J">JD Claus</name></author><author><name sortKey="Manfro, R" uniqKey="Manfro R">R Manfro</name></author><author><name sortKey="Lima, Sm" uniqKey="Lima S">SM Lima</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schneider, M" uniqKey="Schneider M">M Schneider</name></author><author><name sortKey="Tzscharnke, O" uniqKey="Tzscharnke O">O Tzscharnke</name></author><author><name sortKey="Pilling, E" uniqKey="Pilling E">E Pilling</name></author><author><name 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Hf" uniqKey="Sailer H">HF Sailer</name></author><author><name sortKey="Zoller, Je" uniqKey="Zoller J">JE Zoller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Polley, Jw" uniqKey="Polley J">JW Polley</name></author><author><name sortKey="Figueroa, Aa" uniqKey="Figueroa A">AA Figueroa</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Padwa, Bl" uniqKey="Padwa B">BL Padwa</name></author><author><name sortKey="Kaiser, Mo" uniqKey="Kaiser M">MO Kaiser</name></author><author><name sortKey="Kaban, Lb" uniqKey="Kaban L">LB Kaban</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kaipatur, N" uniqKey="Kaipatur N">N Kaipatur</name></author><author><name sortKey="Al Thomali, Y" uniqKey="Al Thomali Y">Y Al-Thomali</name></author><author><name sortKey="Flores Mir, C" uniqKey="Flores Mir C">C Flores-Mir</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Schendel, Sa" uniqKey="Schendel S">SA Schendel</name></author><author><name sortKey="Jacobson, R" uniqKey="Jacobson R">R Jacobson</name></author><author><name sortKey="Khalessi, S" uniqKey="Khalessi S">S Khalessi</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>France</li><li>Suisse</li></country><region><li>Canton de Genève</li><li>Île-de-France</li></region><settlement><li>Genève</li><li>Paris</li></settlement><orgName><li>Université de Genève</li></orgName></list><tree><country name="France"><region name="Île-de-France"><name sortKey="Schouman, Thomas" sort="Schouman, Thomas" uniqKey="Schouman T" first="Thomas" last="Schouman">Thomas Schouman</name></region><name sortKey="Rouch, Philippe" sort="Rouch, Philippe" uniqKey="Rouch P" first="Philippe" last="Rouch">Philippe Rouch</name></country><country name="Suisse"><noRegion><name sortKey="Imholz, Benoit" sort="Imholz, Benoit" uniqKey="Imholz B" first="Benoît" last="Imholz">Benoît Imholz</name></noRegion><name sortKey="Courvoisier, Delphine" sort="Courvoisier, Delphine" uniqKey="Courvoisier D" first="Delphine" last="Courvoisier">Delphine Courvoisier</name><name sortKey="Fasel, Jean" sort="Fasel, Jean" uniqKey="Fasel J" first="Jean" last="Fasel">Jean Fasel</name><name sortKey="Scolozzi, Paolo" sort="Scolozzi, Paolo" uniqKey="Scolozzi P" first="Paolo" last="Scolozzi">Paolo Scolozzi</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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