Evidence map›Paper›PMID 39671058›Full record

ArticleInternational journal of computer assisted radiology and surgery2025

Fronto-orbital advancement with patient-specific 3D-printed implants and robot-guided laser osteotomy: an in vitro accuracy assessment.

Michaela Maintz, Nora Desan, Neha Sharma, Jörg Beinemann, Michel Beyer, Daniel Seiler, Philipp Honigmann, Jehuda Soleman, Raphael Guzman, Philippe C Cattin and 1 more

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Article in International journal of computer assisted radiology and surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Trial
  2. Review
  3. Review
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  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Michaela MaintzMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.ORCID http://orcid.org/0000-0003-4502-3655
Nora DesanMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.
Neha SharmaMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland. neha.sharma@unibas.ch.ORCID http://orcid.org/0000-0003-3299-0945
Jörg BeinemannClinic Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Basel, Switzerland.
Michel BeyerMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.ORCID http://orcid.org/0009-0002-5377-1530
Daniel SeilerInstitute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, Muttenz, Switzerland.ORCID http://orcid.org/0000-0002-9772-1132
Philipp HonigmannMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.ORCID http://orcid.org/0000-0002-4743-5082
Jehuda SolemanDepartment of Neurosurgery, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0003-1900-9286
Raphael GuzmanDepartment of Neurosurgery, University Hospital Basel, Basel, Switzerland.ORCID http://orcid.org/0000-0001-9620-0581
Philippe C CattinCenter of Medical Image Analysis and Navigation (CIAN), Department of Biomedical Engineering, University of Basel, Allschwil, Basel, Switzerland.ORCID http://orcid.org/0000-0001-8785-2713
Florian M ThieringerMedical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, Allschwil, Switzerland.ORCID http://orcid.org/0000-0003-3035-9308

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe use of computer-assisted virtual surgical planning (VSP) for craniosynostosis surgery is gaining increasing implementation in the clinics. However, accurately transferring the preoperative planning data to the operating room remains challenging. We introduced and investigated a fully digital workflow to perform fronto-orbital advancement (FOA) surgery using 3D-printed patient-specific implants (PSIs) and cold-ablation robot-guided laser osteotomy. This novel approach eliminates the need for traditional surgical templates while enhancing precision and customization, offering a more streamlined and efficient surgical process.

methodsComputed tomography data of a patient with craniosynostosis were used to digitally reconstruct the skull and to perform VSP of the FOA. In total, six PSIs per skull were 3D-printed with a medical-grade bioresorbable composite using the Arburg Plastic Freeforming technology. The planned osteotomy paths and the screw holes, including their positions and axis angles, were digitally transferred to the cold-ablation robot-guided osteotome interface. The osteotomies were performed on 3D-printed patient skull models. The implants, osteotomy and final FOA results were scanned and compared to the VSP data.

resultsThe osteotomy deviations for the skulls indicated an overall maximum distance of 1.7 mm, a median deviation of 0.44 mm, and a maximum root mean square (RMS) error of 0.67 mm. The deviation of the point-to-point surface comparison of the FOA with the VSP data resulted in a median accuracy of 1.27 mm. Accessing the orbital cavity with the laser remained challenging.

conclusionThis in vitro study showcases a novel FOA technique by effectively combining robot-guided laser osteotomy with 3D-printed patient-specific implants, eliminating the need for surgical templates and achieving high accuracy in bone cutting and positioning. The workflow holds promise for reducing preoperative planning time and increasing surgical efficiency. Further studies on bone tissue are required to validate the safety and effectiveness of this approach, especially in addressing the challenges of pediatric craniofacial surgery.

Indexed as

CraniosynostosesFrontal BoneLaser TherapyOrbitOsteotomyPrinting, Three-DimensionalProstheses and ImplantsRobotic Surgical ProceduresSurgery, Computer-AssistedHumansTomography, X-Ray ComputedComputer-aided designCraniosynostosisLaser osteotomePatient-specific implantsPediatricsRobot-assisted surgery

Identifiers

PMID39671058
PMCPMC11929943

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.