Patient-specific dynamic reference frame for navigation-assisted surgery in mandible: a novel noninvasive technical method

Objectives: Computer-assisted navigation has been established as a valuable tool in oral and craniomaxillofacial surgery. However, the steep learning curve associated with mandibular navigation surgery has hindered its widespread adoption. This study introduces a non-invasive, convenient, and accurate navigation method for mandibular surgery and evaluates its clinical effectiveness. Methods: A modified patient-specific dynamic reference frame (PS-DRF) was designed and fabricated based on the patient's lower jaw dental cast, integrating navigation technology with 3D printing. During surgery, the PS-DRF was securely affixed to the lower dentition, enabling automatic pair-point registration through fiducial localization via a navigation probe. The surgical procedure was conducted under real-time navigation guidance. Results: Preoperative registration and intraoperative navigation were successfully achieved in this case. The navigation-guided mandibular surgery was completed without complications. Postoperative superimposition of the simulated virtual model and the actual surgical outcome demonstrated high accuracy, with a deviation of less than 2 mm. Conclusion: The PS-DRF system offers a convenient, effective, and adaptable approach by integrating navigation technology with 3D printing. This method has the potential to simplify navigation-assisted mandibular surgery and facilitate the broader clinical implementation of computer-assisted navigation in maxillofacial procedures.