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Objective@# Using computer-assisted navigation technology to guide the resection and reconstruction of mandibular ameloblastoma, evaluating its treatment effect.@*Methods @# Twelve patients were selected from the Affiliated Stomatological Hospital of Nanjing University from January 2017 to May 2022. All 12 patients accepted same surgery which included resection of mandibular ameloblastoma and reconstruction by fibula musculocutaneous flap. Among them, 6 cases were included in the navigation group; 6 cases were in the non-navigation group. Advantages and disadvantages of computer-assisted navigation technology in this operation were evaluated with these cases. @*Results@# The 12 operations were performed by the same operator. The average time for fixing the navigation bracket and performing navigation in the navigation group was about 15 minutes. Compared with the non-navigation group, the average operation time in the navigation group was shortened by about 10 minutes. In the navigation group, the mandible resection range matched the fibula musculocutaneous flap well, and the occlusal relationship recovered well. @*Conclusion @#Using the mandibular reference frame, under the guidance of computer-assisted navigation technology, the resection and reconstruction of mandibular ameloblastoma can be performed quickly and accurately.
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Objective @#To compare the accuracies of implants with dynamic real-time navigation versus digital guide navigation to provide a reference for clinical precision dental implants. @*Methods@#Forty-six cases (seventy teeth) with missing teeth admitted to the Department of Stomatology, Wuzhou Red Cross Hospital from April 2018 to December 2019 were randomly divided into two groups (thirty-five teeth in each group) for dynamic real-time navigation and digital guide navigation implantation techniques. To compare the entry point, apex point, depth and angle deviation of the preoperative and postoperative position of implants in the two groups. SPSS 21.0 software was used for statistical analysis.@*Results @#Dental implants were successfully placed in both groups. The deviations of apex point, depth and angle in the dynamic real-time navigation group were all smaller than those in the digital guide navigation group, and the differences were statistically significant (P < 0.05). There was no statistically significant deviation in the entry point between the two groups (P > 0.05). @*Conclusion@#In this study, both techniques had good clinical effects. The accuracy of dynamic real-time navigation was higher than that of digital guidance.
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@#Digital implant guides have enabled "repair-oriented" implant restoration to become a reality by allowing an implant to be designed for an ideal site, maximizing the use of existing alveolar bone, and increasing the predictability of the restorative effect. This paper reviews the classification of digital guides and the related factors affecting the accuracy of digital guides to provide a reference for clinical doctors in practical applications. Digital guides can be divided into the categories of mucosal support, bone support, dental support and mixed support according to the retention mode. The manufacture and use of digital implant guides involve a series of processes, such as data acquisition, design and manufacture of the implant guide, and guided surgery. The accuracy of digital implant guides depends on all accumulated and interactive errors involved in the process from data acquisition to surgery. According to the process of guide plate fabrication and implant placement, errors in all aspects can be reduced to improve the accuracy of guide plate application.
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Objective:To present our experience of the surgical treatment of maxillofacial fibrous dysplasia(FD) using surgical navigation technology.Methods:14 patients with maxillofacial FD were included.Preoperative CT scanning data were obtained and a virtual plan based on the patient's mirrored anatomy was realized.Intraoperatively,a digital reference frame was fixed rigidly to patient's forehead or mandible depending on the location of the lesion.During operation each patient and the virtual image were matched through individual registration technique.A pointing device was constantly used to determine whether the extent of resection was consistent with the preoperative design.The surgical outcome was assessed through fusion of the preoperative planning and postoperative CT reconstruction image.Results:The application of surgical navigation system enhanced the safety and the accuracy of the surgery for the resection of the focal lesion and for the recontour of the profile.There was no complications during 1-3 years follow up.Conclusion:Surgical navigation based on a virtual plan proves to be safe and accurate,and is of great value in managing maxillofacial fibrous dysplasia.
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Objective To apply the three-dimensional pre-operative simulation and intra-operative real-time navigation in the reconstruction of old maxillofacial fractures so as to increase the surgical precision. Methods Six patients with old maxillofacial fractures were enrolled, and the diagnosis of unilateral old maxillofacial fractures was confirmed by clinical and imaging examinations. Virtual three-dimensional skull models were reconstructed from pre-operative CT images. The fractured bone was moved or rotated, and was reposed in a desired site according to the mirrored part from the healthy side. After patient-to-image registration, the surgical instruments and patients were tracked in real-time by optical tracking system during operation, and in this way the maxillofacial fractures were reposed satisfactorily guided by the virtual image. Results Three-dimensional simulation before operation and real-time navigation of patients and instruments during operation were realized. The error of registration was less than 1 mm. The post-operative CT examinations of these six patients revealed that the fracture reposition was same to the pre-operative planning, and the difference between them was less than 1.5 mm. The operations were minimally-invasive, with no complications. Conclusion Computer-aided surgical simulation and navigation system can effectively increase the surgical precision of reconstruction of old maxillofacial fractures.
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Objective To study the work principle and key technologies of digital surgery navigation system of Stryker NavSuiteTM.Methods Applying principles which contained intelligence tracing,virtual reality,image processing,system registration and so on,surgery navigation system constructed three-dimensional virtual anatomy of the patient to realize the precise navigation in surgery.Results The navigation system could provide real-time and three-dimensional navigation safely,precisely and reliably.This system assisted doctor to complete the extremely difficult minimal invasive surgery.Conclusion The digital surgery navigation system is the most advanced and innovative technique.This system is one of the important parts of digital operating room.It is also significant for promoting the hospital to obtain the maximum economic benefit and social benefit.