Mr-Based Bone Registration/Positioning Technology For Orthognathic-Tmj Surgery

The management of secondary dentofacial deformities with TMJ disorders typically involves orthognathic-TMJ combined surgical intervention. The surgical intervention frequently utilizes computer-assisted surgical planning to guide procedures. The transfer of a virtual surgical plan (VSP) significantly impacts postoperative occlusion, TMJ function, etc., commonly employing a guide-splint-plate positioning system, which achieves high positioning accuracy yet entails considerable technical intricacy during implementation. Mixed Reality (MR) technology, an emerging innovation derived from the convergence of Virtual Reality (VR) and Augmented Reality (AR), has been extensively integrated into diverse medical practices. We have implemented MR technology in orthognathic-TMJ combined surgical interventions, achieving MR-based precise bone registration and intraoperative positioning/navigation, which enables VSP transfer without complex guidance systems, while facilitating dynamic intraoperative navigation and positioning under direct visualization. We have successfully performed multiple MR-guided surgical procedures for secondary dentofacial deformities with TMJ disorders, achieving registration errors ≤1 mm and registration latency of 0.3 seconds. Following successful transfer of the Virtual VSP to the operative field, MR-based bone registration enables real-time visualization of skeletal segment positioning accuracy. For instance: during simultaneous TMJ reconstruction and orthognathic surgery, mandibular opening/closing maneuvers allow direct observation of condyle-fossa relationship dynamics; post Le Fort I osteotomy, MR guidance facilitates dynamic tracking of distal segment mobilization to optimize three-dimensional repositioning. These outcomes demonstrate favorable registration accuracy and postoperative stability, while effectively streamlining surgical workflows and reducing intraoperative tissue trauma, indicating significant clinical potential for broader implementation.