Augmented Reality-Assisted Navigation For Mandibular Distraction Osteogenesis

This study aims to evaluate the effectiveness and clinical feasibility of optical tracking–based augmented reality (AR) navigation technology in mandibular distraction osteogenesis (MDO) procedures. Thirty mandibular models were divided into AR, surgical guide (SG), and freehand (FH) groups; 32 Beagle dogs were allocated to AR, SG, FH, and traditional navigation (TN) groups; and Two cadaver trials were conducted to simulate real surgeries. Primary outcomes assessed included osteotomy accuracy, distraction vector deviation, distractor placement error, intraoperative challenges, and operative time. In the mandibular model experiment, the AR group demonstrated superior accuracy in distractor angulation, positioning, and osteotomy compared to the freehand (FH) group, with performance comparable to the surgical guide (SG) group. In the animal study, the AR group exhibited lower errors in distractor placement, osteotomy positioning, and angulation than both the FH and traditional navigation (TN) groups, and achieved more accurate placement than the SG group. Additionally, the AR group recorded the lowest average number of intraoperative challenges.In human cadaver head experiments, AR navigation surgeries achieved distraction device installation precision within the expected pre-surgical plan, with error ranges within acceptable limits. The AR holographic navigation platform with integrated optical tracking demonstrated clinically acceptable accuracy and latency. It achieved comparable or superior outcomes to surgical guides in both model and animal studies, and significantly outperformed manual techniques, confirming its feasibility and effectiveness for mandibular distraction osteogenesis procedures.