Development of a preoperative computer-aided surgical simulation system for mandibular reconstruction

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K20485
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Dental engineering/Regenerative dentistry
• Research Institution: Nara Medical University
• Principal Investigator: Ueda Nobuhiro 奈良県立医科大学, 医学部, 助教 (40571005)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 下顎再建 / 手術シミュレーション / 下顎切除 / 口腔癌 / 顎骨骨髄炎

Outline of Final Research Achievements

In mandibular reconstruction using free fibular flap, it is important for esthetics to perform sufficient preoperative simulation and to accurately restore the shape of the mandible. In addition, since the esthetics of facial asymmetry after reconstruction have not been sufficiently evaluated, we aimed to develop a preoperative simulation system and establish a method for evaluating esthetics after mandibular reconstruction.
We developed "biGAKU", a virtual preoperative planning software for mandibular reconstructive surgery.
We proposed a quantitative evaluation using 3D facial surface images for the evaluation method of facial asymmetry after mandibular reconstructio, and calculated the correlation with the conventional subjective evaluation. The quantitative evaluation using 3D facial surface image was a result that is a rapid and clinically applicable technology to replace the conventional subjective evaluation.

Free Research Field

口腔癌

Academic Significance and Societal Importance of the Research Achievements

下顎再建術後の整容性の評価として，定量的な評価方法を開発した．3Dカメラを用い3D顔面サーフェス画像に正中を検出し，この正中線にて再建側と非再建側を重ね合わせた．この両者間の誤差として生じる「差分体積」「最大陥凹値」は，現在まで用いられていたスコアによる主観評価の結果と相関しており，有用な方法であると考えられた．主観評価は，評価するタイミングや評価者による整容性の捉え方の違いが大きく，これらを定量的にとらえることで解消できるとともに，複数人での評価を行うより短時間での評価を可能とすると思われた．この方法は，顎骨再建術症例のみならず他の顎顔面手術後の患者の整容性の評価に応用できると考えられる．