Reproducibility of a three-dimensional skeletal-based craniofacial orientation method for virtual surgical planning |
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| Affiliation: | 1. Research Program on Integrated Dental Sciences, Faculty of Dentistry of the University of Cuiaba – UNIC, Cuiaba, Mato Grosso, Brazil;2. Department of Oral and Maxillofacial Surgery, General Hospital of Cuiaba, Cuiaba, Mato Grosso, Brazil;3. Research Program on Integrated Dental Sciences, Faculty of Dentistry of the University of Cuiaba – UNIC, Cuiaba, Mato Grosso, Brazil;4. Department of Oral and Maxillofacial Surgery, Traumatology and Prosthesis, Faculty of Dentistry of the University of São Paulo – USP, Sao Paulo, Sao Paulo, Brazil;5. Department of Stomatology, Faculty of Dentistry of the University of São Paulo – USP, Sao Paulo, Sao Paulo, Brazil;6. Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil;7. Department of Oral and Maxillofacial Surgery, University of Illinois – UIC, Chicago, IL, United States;8. Research Program on Integrated Dental Sciences, Faculty of Dentistry of the University of Cuiaba – UNIC, Cuiaba, Mato Grosso, Brazil;1. Master''s student in Orofacial Harmonization - European Face Institute, Porto, Portugal;2. Oral and Maxillofacial Surgeon, Master in Oral and Maxillofacial Surgery, PhD in Oral and Maxillofacial Sugery, Maxillofacial Program Director - European Face Institute, Porto, Portugal;1. GSR Hospital, Hyderabad, Telangana, India;2. Department of Otorhinolaryngology, Head & Neck Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;3. Sri Sai College of Dental Surgery, Department of Oral and Maxillofacial Surgery, Vikarabad, Telangana, India;4. Department of Oral and Maxillofacial Surgery, Radboud University Medical Centre, Nijmegen, The Netherlands;5. Dept. Of Cranio-maxillofacial Surgery, AIIMS, Rishikesh, Uttarakhand, India;1. Department of Prosthesis and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Recife, Brazil;2. Institute of Health and Biological Sciences, Federal University of Alagoas, Maceió, Brazil;3. Human Anatomy Area, Institute of Health and Biological Sciences, Federal University of Alagoas, Maceió, Brazil;4. Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, Brazil;5. Department of Clinical and Preventive Dentistry, Dental School, Federal University of Pernambuco, Recife, Brazil;1. Department of Oral and Maxillofacial Surgery, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK;2. Department of Oral and Maxillofacial Surgery, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK;3. Department of Oral and Maxillofacial Surgery, Forth Valley Royal Hospital, Stirling Rd, Larbert FK5 4WR, UK;4. Department of Medical Physics, University Hospital Crosshouse, Kilmarnock Rd, Crosshouse, Kilmarnock KA2 0BE, UK;5. Department of Radiology & Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK;6. Department of Nuclear Medicine, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK;7. Department of Pathology, Queen Elizabeth University Hospital, 1345 Govan Road, Glasgow G51 4TF, UK;1. Department of Oral and Maxillofacial Surgery, TU Dental Teaching Hospital, MMC, Institute of Medicine, Kathmandu, Nepal;2. Oral and Maxillofacial Surgery, Private Practice, New Delhi, India;3. Ek Ek Paila Foundation, Kathmandu, Nepal;4. Department of Oral Biology, Chitwan Medical College, Bharatpur, Nepal;5. Department of Oral and Maxillofacial Surgery, CDER, AIIMS, New Delhi, India |
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| Abstract: | Inadequate craniofacial orientation of computed tomography (CT) scans can have significant implications in all three planes of space. The purpose of this study was to present the reproducibility of a 3-dimensional skeletal-based method of craniofacial orientation for virtual surgical planning. The protocol was defined by landmarks commonly used for cephalometry, and required identification of basion, nasion, right porion, and right orbitale, and navigation in all CT views (coronal, sagittal, and axial) for correction of yaw, roll, and pitch. Reproducibility of the method was assessed using eight CT scans that were randomly selected and anonymised. The observer group consisted of six oral and maxillofacial surgeons with varying levels of experience (resident or faculty) who performed craniofacial orientation according to the proposed method. Results were expected to be below 2° of variation, when overall accuracy as well as the influence of the academic level of the observers and symmetry of the evaluated anatomy, were considered as independent variables. Overall accuracy for all cases and for yaw, roll, and pitch were always below 2° of variation, without influence of level of experience and symmetry. Interobserver assessment was categorised as excellent in all instances, and intraobserver evaluation demonstrated consistency in the orientation of all axes. The proposed craniofacial orientation protocol presented in this study is easy to learn, applicable to computer-aided surgical planning, and can be performed by the non-technical clinician, resulting in excellent reproducibility and consistency. |
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| Keywords: | Head orientation Orthognathic surgery Virtual surgical planning |
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