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Utilization of a 3D printed dental splint for registration during electromagnetically navigated mandibular surgery

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

A dental splint was developed for non-invasive rigid point-based registration in electromagnetically (EM) navigated mandibular surgery. Navigational accuracies of the dental splint were compared with the common approach, that is, using screws as landmarks.

Methods

A dental splint that includes reference registration notches was 3D printed. Different sets of three points were used for rigid point-based registration on a mandibular phantom: notches on the dental splint only, screws on the mandible, contralateral screws (the side of the mandible where the sensor is not fixated) and a combination of screws on the mandible and notches on the dental splint. The accuracy of each registration method was calculated using 45 notches at one side of the mandible and expressed as the target registration error (TRE).

Results

Average TREs of 0.83 mm (range 0.7–1.39 mm), 1.28 mm (1.03–1.7 mm), 2.62 mm (1.91–4.0 mm), and 1.34 mm (1.30–1.39 mm) were found, respectively, for point-based registration based on the splint only, screws on the mandible, screws on the contralateral side only, and screws combined with the splint.

Conclusion

For dentate patients, rigid point-based registration performs best utilizing a dental splint with notches. The dental splint is easy to implement in the surgical, and navigational, workflow, and the notches can be pinpointed and designated on the CT scan with high accuracy. For edentate patients, screws can be used for rigid point-based registration. However, a new design of the screws is recommended to improve the accuracy of designation on the CT scan.

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Acknowledgements

The Netherlands Cancer Institute received a research grant from ATOS Medical Sweden, which contributes to the existing infrastructure for health-related, quality-of-life research in the Department of Head and Neck Oncology and Surgery of the Antoni van Leeuwenhoek Hospital. In addition, the research was partly funded by the Verwelius foundation (Huizen, the Netherlands).

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Authors and Affiliations

  1. Verwelius 3D Lab, Department of Head and Neck Surgery and Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam, The Netherlands

    S. G. Brouwer de Koning, M. J. A. van Alphen, W. H. Schreuder, L. H. E. Karssemakers, M. B. Karakullukcu & R. L. P. van Veen

  2. Faculty of Science and Technology, University of Twente, Enschede, The Netherlands

    J. J. M. Riksen, T. P. ter Braak & F. van der Heijden

Authors
  1. S. G. Brouwer de Koning
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  2. J. J. M. Riksen
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  3. T. P. ter Braak
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  4. M. J. A. van Alphen
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  5. F. van der Heijden
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  6. W. H. Schreuder
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  7. L. H. E. Karssemakers
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  8. M. B. Karakullukcu
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  9. R. L. P. van Veen
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Contributions

All authors have contributed to the research described in this manuscript.

Corresponding author

Correspondence to R. L. P. van Veen.

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Brouwer de Koning, S.G., Riksen, J.J.M., ter Braak, T.P. et al. Utilization of a 3D printed dental splint for registration during electromagnetically navigated mandibular surgery. Int J CARS 15, 1997–2003 (2020). https://doi.org/10.1007/s11548-020-02271-3

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  • DOI: https://doi.org/10.1007/s11548-020-02271-3

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