Implant-oriented navigation in orbital reconstruction. Part 1: technique and accuracy study. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: Schreurs, R.; Dubois, L.; Becking, A.G.; Maal, T.J.J.
• Is Part Of: International journal of oral & maxillofacial surgery. Volume 47:Issue 3(2018:Mar.)
• Page Start: 395
• Page End: 402
• Publication Date: 2018-03
• Subjects: intraoperative navigation -- orbital reconstruction -- orbit -- real-time -- feedback; Mouth -- Surgery -- Periodicals; Maxilla -- Surgery -- Periodicals; Dentistry -- Periodicals; Dentistry, Operative; Oral Surgical Procedures; Surgery, Oral; Dentistry; Maxilla -- Surgery; Mouth -- Surgery; Electronic journals; Periodicals; 617.52059
• DOI: 10.1016/j.ijom.2017.09.009
• Languages: English
• ISSNs: 0901-5027

Abstract

Abstract: Intraoperative navigation is frequently used to assess the position of the implant in orbital reconstruction. Interpretation of the feedback from the navigation system to a three-dimensional position of the implant needs to be done by the surgeon, and feedback is only gathered after the implant has been positioned. An implant-oriented navigation approach is proposed, with real-time intuitive feedback during insertion. A technical framework was set up for implant-oriented navigation, with requirements for planning, implant tracking, and feedback. A dedicated navigation instrument was designed and a software tool was developed in order to meet the technical requirements. An accuracy study was performed to investigate the accuracy of the method in comparison to the regular navigation pointer. A proof of concept was provided. The results showed a translation error of 1.12–1.15 mm for implant-oriented navigation with regular registration (pointer 0.71–0.98 mm) and 0.81 mm with accurate registration (pointer 0.54 mm). Rotational error was found to be small (<3°). Quantitative and intuitive qualitative feedback could be provided to the surgeon in real-time during insertion of an orbital implant. Following this proof of concept and accuracy study, the implications for the clinical workflow should be evaluated. An implant-oriented approach may form the foundation for augmented reality or robotic-aided implant insertion.