Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study.
Accuracy of a computer-aided surgical simulation protocol for orthognathic surgery: a prospective multicenter study.
复制标题
DOI：
10.1016/j.joms.2012.03.027
复制
发表时间：
2013-01
期刊：
影响因子：
--
通讯作者：
Xia JJ
中科院分区：
文献类型：
--
作者：
Hsu SS;Gateno J;Bell RB;Hirsch DL;Markiewicz MR;Teichgraeber JF;Zhou X;Xia JJ
本前瞻性多中心研究的目的是评估计算机辅助手术模拟（卡斯）方案用于正颌外科手术的准确性。通过比较从3个中心入组的65例连续患者的计划和术后结局，评估卡斯方案的准确性。所有患者均使用计算机生成的手术夹板。对于颏成形术，一家临床试验机构仅对不对称患者使用计算机生成的下巴模板重新定位下巴节段。其余患者使用标准术中测量，不使用下巴模板。主要结果测量是在颅骨处配准计划和术后模型时上颌骨、下颌骨和下巴的线性和角度差异。次要结果测量为：计划位置和术后位置之间的上颌牙中线差异;以及使用和不使用模板的组之间颏段的线性和角度差异。后者是在下颌体部配准计划模型和术后模型时测量的。进行了统计分析，并使用均方根偏差（RMSD）和Bland和Altman方法报告了准确度，以评估测量一致性。在主要结局测量中，3家临床试验机构的上颌骨和下颌骨无统计学显著差异。上颌骨RMSD最大值为1.0mm和1.5°，下颌骨RMSD最大值为1.1mm和1.8°。对于下巴，使用和不使用下巴模板的组之间存在统计学显著差异。下巴模板组显示出出色的准确性，最大位置RMSD为1.0 mm，最大方向RSMD为2.2°。然而，在未使用下巴模板的组中观察到较大的方差。这在前后和上下方向上是显著的，如在俯仰和偏航方向上。在次要结局测量中，上颌牙中线位置的RMSD为0.9mm。当在下颌骨体部进行配准时，使用和不使用颏模板的组之间颏段的线性和角度差异与主要结局测量中发现的结果一致。使用卡斯协议，计算机化的计划可以准确和一致地传输给患者，以在手术时定位上颌骨和下颌骨。与术中测量相比，计算机生成的下巴模板在重新定位下巴节段方面提供了更高的准确性。
The purpose of this prospective multicenter study was to assess the accuracy of a computer-aided surgical simulation (CASS) protocol for orthognathic surgery. The accuracy of the CASS protocol was assessed by comparing planned and postoperative outcomes of 65 consecutive patients enrolled from 3 centers. Computer-generated surgical splints were used for all patients. For the genioplasty, one center utilized computer-generated chin templates to reposition the chin segment only for patients with asymmetry. Standard intraoperative measurements were utilized without the chin templates for the remaining patients. The primary outcome measurements were linear and angular differences for the maxilla, mandible and chin when the planned and postoperative models were registered at the cranium. The secondary outcome measurements were: maxillary dental midline difference between the planned and postoperative positions; and linear and angular differences of the chin segment between the groups with and without the use of the template. The latter was measured when the planned and postoperative models were registered at mandibular body. Statistical analyses were performed, and the accuracy was reported using root mean square deviation (RMSD) and Bland and Altman's method for assessing measurement agreement. In the primary outcome measurements, there was no statistically significant difference among the 3 centers for the maxilla and mandible. The largest RMSD was 1.0mm and 1.5° for the maxilla, and 1.1mm and 1.8° for the mandible. For the chin, there was a statistically significant difference between the groups with and without the use of the chin template. The chin template group showed excellent accuracy with largest positional RMSD of 1.0mm and the largest orientational RSMD of 2.2°. However, larger variances were observed in the group not using the chin template. This was significant in anteroposterior and superoinferior directions, as in pitch and yaw orientations. In the secondary outcome measurements, the RMSD of maxillary dental midline positions was 0.9mm. When registered at the body of the mandible, the linear and angular differences of the chin segment between the groups with and without the use of the chin template were consistent with the results found in the primary outcome measurements. Using the CASS protocol, the computerized plan can be accurately and consistently transferred to the patient to position the maxilla and mandible at the time of surgery. The computer-generated chin template provides more accuracy in repositioning the chin segment than the intraoperative measurements.
登录
查看更多内容
影响因子：
1.9
作者：
Malis, Didier-David;Xia, James J.;Teichgraeber, John E.
通讯作者：
Teichgraeber, John E.
DOI：
10.1054/ijom.2002.0278
发表时间：
2002-08-01
影响因子：
2.4
作者：
Troulis, MJ;Everett, R;Kaban, LB
通讯作者：
Kaban, LB
影响因子：
1.9
作者：
Gateno, J;Xia, J;Rosen, A
通讯作者：
Rosen, A
影响因子：
0.9
作者：
Swennen, Gwen R. J.;Mommaerts, Maurice Y.;Schutyser, Filip
通讯作者：
Schutyser, Filip
影响因子：
1.9
作者：
Gateno, Jaime;Xia, James J.;Briggs, Michaelanne E.
通讯作者：
Briggs, Michaelanne E.