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Brief Report

Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application

by
Masahide Koyachi
1,
Keisuke Sugahara
1,*,
Kotaro Tachizawa
1,
Akihiro Nishiyama
1,
Kento Odaka
2,
Satoru Matsunaga
3,
Maki Sugimoto
1,4,
Chie Tachiki
5,
Yasushi Nishii
5 and
Akira Katakura
1
1
Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
2
Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
3
Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
4
Innovation Lab, Teikyo University Okinaga Research Institute, 2-16-1 Hirakawacho Chiyoda-ku, Tokyo 102-0093, Japan
5
Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2023, 12(23), 7408; https://doi.org/10.3390/jcm12237408
Submission received: 26 September 2023 / Revised: 26 October 2023 / Accepted: 27 November 2023 / Published: 29 November 2023
(This article belongs to the Special Issue Innovation in Facial Plastic and Aesthetic Surgery)
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Abstract

Genioplasty is performed for the orthognathic surgical correction of dentofacial deformities. This article reports a safe and accurate method for genioplasty combining a novel three-dimensional (3D) device with mixed reality (MR)-assisted surgery using a registration marker and a head-mounted display. Four types of devices were designed based on the virtual operation: a surgical splint with a connector; an osteotomy device; a repositioning device; and a registration marker. Microsoft HoloLens 2 and Holoeyes MD were used to project holograms created using computed tomography (CT) data onto the surgical field to improve the accuracy of the computer-aided designed and manufactured (CAD/CAM) surgical guides. After making an incision on the oral vestibule, the splint was fitted on the teeth and the osteotomy device was mounted at the junction site, placed directly on the exposed mandible bone surface. Temporary screws were fixed into the screw hole. An ultrasonic cutting instrument was used for the osteotomy. After separating the bone, a repositioning device was connected to the splint junction and bone segment, and repositioning was performed. At the time of repositioning, the registration marker was connected to the splint junction, and mandible repositioning was confirmed three-dimensionally through HoloLens 2 into the position specified in the virtual surgery. The rate of overlay error between the preoperative virtual operation and one-month postoperative CT data within 2 mm was 100%. CAD/CAM combined with MR enabled accurate genioplasty.
Keywords: computer-aided design and manufacturing; mixed reality; genioplasty; orthognathic surgery computer-aided design and manufacturing; mixed reality; genioplasty; orthognathic surgery

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MDPI and ACS Style

Koyachi, M.; Sugahara, K.; Tachizawa, K.; Nishiyama, A.; Odaka, K.; Matsunaga, S.; Sugimoto, M.; Tachiki, C.; Nishii, Y.; Katakura, A. Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application. J. Clin. Med. 2023, 12, 7408. https://doi.org/10.3390/jcm12237408

AMA Style

Koyachi M, Sugahara K, Tachizawa K, Nishiyama A, Odaka K, Matsunaga S, Sugimoto M, Tachiki C, Nishii Y, Katakura A. Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application. Journal of Clinical Medicine. 2023; 12(23):7408. https://doi.org/10.3390/jcm12237408

Chicago/Turabian Style

Koyachi, Masahide, Keisuke Sugahara, Kotaro Tachizawa, Akihiro Nishiyama, Kento Odaka, Satoru Matsunaga, Maki Sugimoto, Chie Tachiki, Yasushi Nishii, and Akira Katakura. 2023. "Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application" Journal of Clinical Medicine 12, no. 23: 7408. https://doi.org/10.3390/jcm12237408

APA Style

Koyachi, M., Sugahara, K., Tachizawa, K., Nishiyama, A., Odaka, K., Matsunaga, S., Sugimoto, M., Tachiki, C., Nishii, Y., & Katakura, A. (2023). Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application. Journal of Clinical Medicine, 12(23), 7408. https://doi.org/10.3390/jcm12237408

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