A surgical navigated cutting guide for mandibular osteotomies: accuracy and reproducibility of an image-guided mandibular osteotomy

Timon Peter ter Braak, Susan Gijsbertje Brouwer de Koning, Maarten Jan Antony van Alphen, Ferdinand van der Heijden, Willem Hans Schreuder, Robert Leonardus Petrus van Veen, Munir Baris Karakullukcu*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
72 Downloads (Pure)


Purpose: 3D-printed cutting guides are the current standard to translate the virtual surgery plan to the intraoperative setting. The production of these patient-specific cutting guides is time-consuming and costly, and therefore, alternative approaches are currently subject of research. The aim of this study was to assess the accuracy and reproducibility of using a novel electromagnetic (EM) navigated surgical cutting guide to perform virtually planned osteotomies in mandible models. Methods: A novel 3D navigated cutting guide (dubbed Bladerunner) was designed and evaluated with a total of 20 osteotomies, performed on plaster mandibular models according to preoperative planning using EM navigation. The pre- and postoperative scans were registered, and the difference between the preoperatively planned osteotomy and the performed osteotomy was expressed as the distance between the planned and performed cutting planes, and the yaw and roll angles between the planes. Results: The mean difference in distance between the planned osteotomy and performed osteotomy was 1.1 mm (STD 0.6 mm), the mean yaw was 1.8° (STD 1.4°), and mean roll was 1.6° (STD 1.3°). Conclusion: The proposed EM navigated cutting guide for mandibular osteotomies demonstrated accurate positioning of the cutting plane according to the preoperative virtual surgical plan with respect to distance, yaw and roll angles. This novel approach has the potential to make the use of 3D-printed cutting guides obsolete, thereby decreasing the interval between diagnosis and surgery, reduce cost and allow for adaptation of the virtual plan in case of rapid tumor proliferation or unanticipated in situ deviations from the preoperative CT/MR imaging.

Original languageEnglish
Pages (from-to)1719-1725
Number of pages7
JournalInternational journal of computer assisted radiology and surgery
Issue number10
Early online date28 Jul 2020
Publication statusPublished - 1 Oct 2020


  • UT-Hybrid-D
  • Cutting guide
  • Electromagnetic
  • Intraoperative navigation
  • Oral and maxillofacial surgery
  • Presurgical virtual planning
  • Surgical navigation
  • Computer-assisted surgery
  • 22/2 OA procedure


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