Orthognathic surgery is used to treat severe congenital/ developmental craniofacial anomalies and dentofacial malocclusion. It is estimated that over 2.5% of the US population has severe dentofacial deformities requiring orthognathic surgery. Left uncorrected, these malocclusions can lead to psychological distress, impaired masticatory, speech and respiratory functions affecting the overall quality of life. Surgical techniques have improved over the past 50 years with rigid screw fixation decreasing post-operative complications and improving the success rate, yet surgical relapse still occurs. Approximately 20% of patients who had mandibular advancement surgery, with or without maxillary advancement surgery, experience moderate relapse 1-5 years after surgery. In addition, the success rate for more complex maxilla-mandibular surgery is reported to be as low as 60%. A principle component responsible for surgical relapse is due to improper positioning of the condyle and ramus during surgery. The displacement of the proximal segment of the mandible (ramus) produces a stretching of the muscles of mastication while patient is anesthesized. The stretch of the mastication muscles leads eventually to a relapse of the ramus to its original position. Therefore, intra-operative technique(s) or protocol that can assist surgeons in guiding the ramus/ condyle complex back into its biologically stable pre-operative position, should reduce surgical relapse and improve treatment outcomes. The goal of this project is to incorporate freehand ultrasound imaging technology with real-time 3-D image registration techniques to help Oral Maxillofacial Surgeons visualize the proximal segment mandible and guide it back into its stable pre-operative position. Our hypothesis is that a robust surgical navigation system with a real-time intra-operative visualization capability will improve the efficacy and safety of orthognathic surgery.
The specific aims of phase I are (a) develop, prototype, and test algorithms for orthognathic surgery planning, navigation and visualization and (b) Integrate the algorithmic components into a complete Ultrasound-guided navigation software system and evaluate the system using a phantom. Following the Phase I feasibility demonstration, we will refine the system and conduct an extensive study in Phase II.

Public Health Relevance

Orthognathic surgery is used to treat severe congenital/ developmental craniofacial anomalies and dentofacial malocclusion. It is estimated that over 2.5% of the US population has severe dentofacial deformities requiring orthognathic. Left uncorrected, these malocclusions can lead to psychological distress, impaired masticatory, speech and respiratory functions affecting the overall quality of life. Although surgical techniques have improved over the past 50 years, relapses still occur due to the inability to visualize in real- time the position of the ramus/ condyle complex and the pre-operative position the ramus. To address this need, we propose to develop intra-operative visualization technique that incorporates freehand ultrasound imaging technology and 3-D image registration techniques to assist oral maxillofacial surgeons,

Agency
National Institute of Health (NIH)
Institute
National Institute of Dental & Craniofacial Research (NIDCR)
Type
Small Business Innovation Research Grants (SBIR) - Phase I (R43)
Project #
1R43DE024334-01
Application #
8710950
Study Section
Special Emphasis Panel (ZRG1-MOSS-K (11))
Program Officer
Fischer, Dena
Project Start
2014-08-05
Project End
2015-07-31
Budget Start
2014-08-05
Budget End
2015-07-31
Support Year
1
Fiscal Year
2014
Total Cost
$224,850
Indirect Cost
Name
Kitware, Inc.
Department
Type
DUNS #
010926207
City
Clifton Park
State
NY
Country
United States
Zip Code
12065