• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.44.1-44.6
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• 2015

Background: The present study introduces the design and fabrication of a simple surgical guide with which to perform genioplasty. Methods: A three-dimensional reconstruction of the patient's cranio-maxilla region was built, with a dentofacial skeletal model, then derived from CT DICOM data. A surgical simulation was performed on the maxilla and mandible, using three-dimensional cephalometry. We then simulated a full genioplasty, in silico, using the three-dimensional (3D) model of the mandible, according to the final surgical treatment plan. The simulation allowed us to design a surgical guide for genioplasty, which was then computer-rendered and 3D-printed. The manufactured surgical device was ultimately used in an actual genioplasty to guide the osteotomy and to move the cut bone segment to the intended location. Results: We successfully performed the osteotomy, as planned during a genioplasty, using the computer-aided design and computer-aided manufacturing (CAD/CAM) surgical guide that we initially designed and tested using simulated surgery. Conclusions: The surgical guide that we developed proved to be a simple and practical tool with which to assist the surgeon in accurately cutting and removing bone segments, during a genioplasty surgery, as preoperatively planned during 3D surgical simulations.

• Journal of International Society for Simulation Surgery
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• v.2 no.2
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• pp.80-82
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• 2015

The mandibuloplasty for the facial aesthetic reason has been the one of the most popular procedures in aesthetic facial bone surgery in East Asia. Most East Asian women prefer smaller-looking and smooth-shaped facial contour. Prominent mandible angle which are common in Asia would be the main problem for smooth facial contour. In addition, recently, the mandibular body and broad chin shape also are known to be remodeled in order to get the ideal smooth facial shape. However, mandibuloplasty is not that easy to cut because many patients has inward mandibular angle and the visual field in operation is limited. The aim of this trial is to try to provide the prefabricated cutting guide for the symmetric and appropriate mandibuloplasty with the surgeons. Preoperative computed tomography(CT) data were processed for the patient and computer simulation model was produced. Then, mandibuloplasty was done on the computer simulation screen. Based on this data, customized cutting guide was made. This prefabricated cutting guide was used in real mandibuloplasty bilaterally. Premade cutting guide for the mandibuloplasty based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the patients in near future.

• Journal of Korean Foot and Ankle Society
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• v.10 no.2
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• pp.238-241
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• 2006

Purpose: The purpose of this study was to figure out the appropriate and systemic insurance charge for the hallux valgus operations. Materials and Methods: 5 Hospitals for hallux valgus operations were analyzed how they have been charging the national health insurance corporation for their operation fees and how to use the estimated guide and authoritive interpretation through the guide book of health insurance medical treatment grant expense and the guide book of Health insurance medical treatment. Results: There are nothing for guiding principle of hallux valgus operations in both books but a guide of Mcbride operation which is approved 'JA-93-KA and JA-31' for operation fee. So majority of hospitals have charged operation fee depending on their own interpretations they like. According to the guide books, there was a authoritive interpretation that simultaneous operation of osteotomy and tendon transfer for cerebral palsy and flat foot can be eatimated as 'osteotomy+JA-93-NA'. Conclusion: Distal soft tissue procedure should be approved as 'JA-93-NAx100%+JA-31x50%' according to the the estimated guide and authoritive interpretation if transected adductor hllucis is transfered to first metatarsal head. So distal chevron osteotomy could be 'JA-30-1-RAx100%+JA-31x50%', proximal metatarsal osteotomy could be 'JA- 93-NAx100%+JA-31-50%+JA-30-1-RAx50%', first metatarsocuneiform joint arthrodesis could be 'JA-93-NAx100%+ JA-31x50%+JA-73-RAx50%'.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.50 no.2
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• pp.70-79
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• 2024

Objectives: The surgical guide is a static computer-assisted device used for implant surgery planning and guidance. By taking an impression and referring to the patients' three-dimensional computed tomography scan of the desired implant site, a surgical guide can be created. During surgery, the surgical guide aids in achieving the designed implant placement position and direction. We examined and evaluated the long-term clinical outcomes of implant surgery using surgical guides. Materials and Methods: This study investigated a total of 15 patients with 32 implants that were placed using surgical guides from 2009 to 2011 with a mean follow-up period extended beyond 10 years. Patient demographics and implant survival rates were recorded. We analyzed marginal bone loss (MBL) by assessing the radiographs acquired at installation, three months after installation, and one month, one, two, and five years after prosthesis delivery. Results: The mean patient age was 57.33 years at implant placement. Of the 32 implants, five implants were placed in the anterior region and 27 implants were in the posterior region. Six implants failed and three of them were replaced, resulting in an 81.25% survival rate. The mean follow-up period was 10 years and nine months. Mean MBL compared to post-installation was significantly higher than at three months after installation, and one month, one, two, and five years after prosthesis delivery. Mean MBL at three months after installation, and one month, one year, and two years were significantly higher compared to the previous visit (P<0.05). However, MBL at five years after prosthesis delivery did not differ significantly compared to at two years. Conclusion: In this study, implant rehabilitation assisted by surgical guides exhibited favorable survival rates. With the limitation of the sample amount in this study, further research and more samples are required to evaluate the long-term clinical effectiveness of surgical guides.

• Korean Journal of Computational Design and Engineering
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• v.20 no.3
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• pp.263-268
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• 2015

Due to an increased sitting time in work, lumbar disc disease is one of the most frequent diseases in modern days, and this occasionally requires surgery for treatment. Endoscopic disc surgery, one of the common disc surgeries, requires a process of inserting a guide needle to the target disc for which the insertion path is manually planned by drawing lines on the patient's skin while monitoring the fluoroscopic view of the lumbar. Such procedure inevitably exposes both surgeon and patient to the fluoroscopy radiation emitted from the c-arm for a long time. To reduce the radiation exposure time, this study proposes a computer assisted method of calculating the 3D guide needle path by using 2D c-arm images of the disc in 3 different angles. Additionally, a method of the guide robot control based on the 3D needle path was developed by implementing the Hand-eye Calibration method to calculate the transformation matrix between the c-arm and robot base coordinate systems. The proposed system was then tested for its accuracy.

• Journal of the Korea Society of Computer and Information
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• v.22 no.12
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• pp.125-130
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• 2017

Screw insertion surgery is frequently required among surgical procedures. Especially, very careful attention should be paid to the insertion of screw in the operation of the cervical vertebra. Therefore, there is a need for a guide that allows the surgeon to reliably and promptly perform treatment by calculating the desired insertion angle and length for screw insertion. In this study, the center and direction of the pedicle were calculated through 3D modeling and 3D vector numerical analysis using the CT or MRI image of the patient for the safe operation of the guide, and based on this, After that, we will implement surgical guide based on this.

• The Journal of Advanced Prosthodontics
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• v.15 no.5
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• pp.259-270
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• 2023

PURPOSE. This study evaluated the reliability of the chair-side CAD-CAM surgical guide (CSG) in the anterior maxilla by comparing its accuracy with the laboratory 3D-printed surgical guide (3DSG) and manual surgical guide (MSG) concerning different levels of dentists' surgical experience. MATERIALS AND METHODS. Ten surgical guides of each type (MSG, 3DSG, and CSG) were fabricated on a control study model with missing right and left central incisors. Sixty implants were placed in 30 study models by two dentists (one inexperienced and one experienced) using three different types of surgical guides. Horizontal deviations at shoulder and at apex, vertical, and angular deviations were measured after superimposing the planned and placed implant positions in the software. Kruskal-Wallis and Mann-Whitney U tests were used to compare the accuracy of three types of surgical guides in each dentist group and the accuracy of each surgical guide between two dentists (α = .05). RESULTS. There were no significant differences in any deviations between CSG and 3DSG, apart from angular deviation, for both dentists' groups. Moreover, both CSG and 3DSG showed no significant differences in accuracy between the two dentists (P > .05). In contrast, MSG demonstrated significant differences from CSG and 3DSG and a significant difference in accuracy between the two dentists (P < .05). CONCLUSION. CSG provides superior accuracy to MSG in implant placement in the maxillary anterior region and is comparable to 3DSG at different levels of surgical experience, while offering the benefits of shorter manufacturing time and reduced patient visits.

• Journal of Periodontal and Implant Science
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• v.53 no.5
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• pp.388-401
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• 2023

Purpose: This study investigated the accuracy of free-hand implant surgery performed by an experienced operator compared to static guided implant surgery performed by an inexperienced operator on an anterior maxillary dental model arch. Methods: A maxillary dental model with missing teeth (No. 11, 22, and 23) was used for this in vitro study. An intraoral scan was performed on the model, with the resulting digital impression exported as a stereolithography file. Next, a cone-beam computed tomography (CBCT) scan was performed, with the resulting image exported as a Digital Imaging and Communications in Medicine file. Both files were imported into the RealGUIDE 5.0 dental implant planning software. Active Bio implants were selected to place into the model. A single stereolithographic 3-dimensional surgical guide was printed for all cases. Ten clinicians, divided into 2 groups, placed a total of 60 implants in 20 acrylic resin maxillary models. Due to the small sample size, the Mann-Whitney test was used to analyze mean values in the 2 groups. Statistical analyses were performed using SAS version 9.4. Results: The accuracy of implant placement using a surgical guide was significantly higher than that of free-hand implantation. The mean difference between the planned and actual implant positions at the apex was 0.68 mm for the experienced group using the free-hand technique and 0.14 mm for the non-experienced group using the surgical guide technique (P=0.019). At the top of the implant, the mean difference was 1.04 mm for the experienced group using the free-hand technique and 0.52 mm for the non-experienced group using the surgical guide technique (P=0.044). Conclusions: The data from this study will provide valuable insights for future studies, since in vitro studies should be conducted extensively in advance of retrospective or prospective studies to avoid burdening patients unnecessarily.

• The Journal of the Korean dental association
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• v.57 no.2
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• pp.100-104
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• 2019

Orthognathic surgery is designed to correct problems of the jaw and face and restore facial harmony. The limitations of orthognathic surgery occur at all steps of the surgical workflow: preoperative planning, simulation, and operation. Many studies have shown the accuracy and advantages of 3 dimensional computer-assisted program for orthognathic surgery. The purpose of this paper is to introduce the accuracy of the maxillary repositioning in patients who underwent orthognathic surgery using a 3 dimensional computer assisted surgery program. The reliability of computer guided orthognathic surgery using splint and surgical guide need to be improved further. The 3 dimensional computer assisted analysis seems to be more precise to interpret than two-dimensional analysis. High-precision planning of orthognathic surgery has predictable results. Three-dimensional computer assisted orthognathic surgery has the following advantages : planned surgical movement is possible, splints guide with CAD/CAM technology; and increase predictable results .Computer assisted simulation surgery ensures accuracy during surgery, thereby facilitating predictable results. It may provide solution that enables surgeon to perform planned surgery more accurately.

• Journal of Korean Foot and Ankle Society
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• v.27 no.3
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• pp.112-116
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• 2023

A 74-year-old female patient, who underwent surgery for a left distal tibiofibular fracture 40 years earlier, visited the hospital with an ankle varus deformity due to malunion. The patient complained of discomfort while walking due to the ankle and hindfoot varus deformity but did not complain of ankle pain. Therefore, correction using supramalleolar osteotomy was planned, and through virtual surgical simulation, it was predicted that a correction angle of 24° and an osteotomy gap open of 12 mm would be necessary. An osteotomy guide and an osteotomy gap block were made using three-dimensional (3D) printing to perform the osteotomy and correct the deformity according to the predicted goal. One year after surgery, it was observed that the ankle varus was corrected according to the surgical simulation, and the patient was able to walk comfortably. Thus, for correction of deformity, virtual surgical simulation and a 3D-printed osteotomy guide can be used to predict the target value for correction. This is useful for increasing the accuracy of correction of the deformity.