Mr-Guided 3D Printing Of Titanium Plates For Orthognathic Surgery

Three-dimensional (3D) printing titanium plates and guide templates-assisted orthognathic surgery have demonstrated improved surgical precision in maxillary positioning. We present a mixed reality (MR)-assisted technique for 3D printing titanium plates and dynamically transferring osteotomy lines and drilling hole positions, aiming to eliminate guide template fabrication and enhance the efficiency of maxillary localization during surgery. The pre-determined drilling holes and osteotomy lines, corresponding to the printed titanium plates, were accurately projected onto the bone surface utlizing real-time localization via an MR headset in combination with QR code-based navigation. The accuracy of maxillary repositioning was assessed with intermediate postoperative CT scans in comparison to the preoperative digital design. Postoperative CT analysis demonstrated clinically acceptable maxillary deviations of less than 1.5 mm. The MR-guided technique offers a novel, template-free approach to maxillary positioning, enhancing surgical accuracy, workflow efficiency, and intraoperative adaptability.