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International Conference on Oral Health and Dentistry

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Intraoperative navigation in oral and maxillofacial surgery
20th Annual World Dental Summit
March 20-22, 2017 Rome, Italy

Emanuele Zavattero, Giovanni Gerbino and Guglielmo Ramieri

Città della Salute e della Scienza Hospital, Italy

Posters & Accepted Abstracts: Dentistry


Aim: Aim of this study is to explore the indication and application of intraoperative navigation in cranio-maxillo-facial surgery. This study introduces our experience with the use of navigational techniques and summarizes its advantages in the oral and maxillofacial field. Patients & Methods: 64 (105) patients including 88 zygomatic-orbital-maxillary fractures, five craniofacial fibrous displasia, five midface tumors, six chronic sinusitis and one case with facial foreign body were enrolled in the study. CT scans were performed and data imported onto the navigational platform (Brainlab, iPlan ENT-CMF 3.0) to plan the operation. The osteotomy lines, amount and range of resection, the reduction position of bony segments and the position and shape of the implants were determined and displayed by preoperative simulation with mirroring and virtual procedures. All operations were performed under the guidance of navigation system (Brainlab, Germany). The postoperative control was obtained for each patients by image-fusion, superimposing the preoperative CT dataset with the virtual template onto the postoperative CT dataset. Results: All operations were performed successfully with the guidance of real-time navigation. Through registration, an accurate match between the real anatomy and the CT images was achieved (mean error < 1 mm). Good coincidence between virtual simulation and surgical result was achieved in all cases. All patients healed uneventfully and function and profile was improved significantly. Discussion & Conclusion: Several studies in cranio-maxillofacial surgery have addressed the benefit and outcome improvement of computer-assisted surgery. In oral and maxillofacial surgery the demands for precision, optimal function and aesthetic results are high and the complex and distorted anatomy with loss of anatomic landmarks makes this type of surgery particularly difficult. The intraoperative control is achieved by real-time instrument tracking during surgery, keeping in mind that registration techniques used is a key element in precision of surgical navigation. To conclude, computer-assisted preoperative planning and surgery thus advance the difficult surgical field of orbital surgery and computer-assisted surgery should be practiced as part of the surgical routine of posttraumatic and primary orbital reconstruction.

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