{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T03:19:32Z","timestamp":1782184772087,"version":"3.54.5"},"reference-count":35,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100008375","name":"University of Basel","doi-asserted-by":"crossref","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Oral Invest"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>This study presents a fully automated digital workflow using artificial intelligence (AI) to create patient-specific cutting guides for mandible-angle osteotomies in facial feminization surgery (FFS). The goal is to achieve predictable, accurate, and safe results with minimal user input, addressing the time and effort required for conventional guide creation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Materials and methods<\/jats:title>\n            <jats:p>Three-dimensional CT images of 30 male patients were used to develop and validate a workflow that automates two key processes: (1) segmentation of the mandible using a convolutional neural network (3D U-Net architecture) and (2) virtual design of osteotomy-specific cutting guides. Segmentation accuracy was assessed through comparison with expert manual segmentations using the dice similarity coefficient (DSC) and mean surface distance (MSD). The precision of the cutting guides was evaluated based on osteotomy line accuracy and fit. Workflow efficiency was measured by comparing the time required for automated versus manual planning by expert and novice users.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The AI-based workflow achieved a median DSC of 0.966 and a median MSD of 0.212\u00a0mm, demonstrating high accuracy. The median planning time was reduced to 1\u00a0min and 38\u00a0s with the automated system, compared to 19\u00a0min and 37\u00a0s for an expert and 26\u00a0min and 39\u00a0s for a novice, representing 10- and 16-fold time reductions, respectively.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>The AI-based workflow is accurate, efficient, and cost-effective, significantly reducing planning time while maintaining clinical precision.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical relevance<\/jats:title>\n            <jats:p>This workflow improves surgical outcomes with precise and reliable cutting guides, enhancing efficiency and accessibility for clinicians, including those with limited experience in designing cutting guides.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00784-025-06459-2","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T08:27:35Z","timestamp":1753432055000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Innovations in gender affirmation: AI-enhanced surgical guides for mandibular facial feminization surgery"],"prefix":"10.1007","volume":"29","author":[{"given":"Michel","family":"Beyer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sead","family":"Abazi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9line","family":"Tourbier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandru","family":"Burde","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shankeeth","family":"Vinayahalingam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert R.","family":"Ile\u0219an","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian M.","family":"Thieringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"issue":"Suppl 1","key":"6459_CR1","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1080\/26895269.2022.2100644","volume":"23","author":"E Coleman","year":"2022","unstructured":"Coleman E, Radix AE, Bouman WP et al (2022) Standards of care for the health of transgender and gender diverse people, version 8. 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