{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:19:43Z","timestamp":1790083183910,"version":"4.0.1"},"reference-count":22,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T00:00:00Z","timestamp":1701216000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP21K17123XXX"],"award-info":[{"award-number":["JP21K17123XXX"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Genioplasty is performed for the orthognathic surgical correction of dentofacial deformities. This article reports a safe and accurate method for genioplasty combining a novel three-dimensional (3D) device with mixed reality (MR)-assisted surgery using a registration marker and a head-mounted display. Four types of devices were designed based on the virtual operation: a surgical splint with a connector; an osteotomy device; a repositioning device; and a registration marker. Microsoft HoloLens 2 and Holoeyes MD were used to project holograms created using computed tomography (CT) data onto the surgical field to improve the accuracy of the computer-aided designed and manufactured (CAD\/CAM) surgical guides. After making an incision on the oral vestibule, the splint was fitted on the teeth and the osteotomy device was mounted at the junction site, placed directly on the exposed mandible bone surface. Temporary screws were fixed into the screw hole. An ultrasonic cutting instrument was used for the osteotomy. After separating the bone, a repositioning device was connected to the splint junction and bone segment, and repositioning was performed. At the time of repositioning, the registration marker was connected to the splint junction, and mandible repositioning was confirmed three-dimensionally through HoloLens 2 into the position specified in the virtual surgery. The rate of overlay error between the preoperative virtual operation and one-month postoperative CT data within 2 mm was 100%. CAD\/CAM combined with MR enabled accurate genioplasty.<\/jats:p>","DOI":"10.3390\/jcm12237408","type":"journal-article","created":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:01:00Z","timestamp":1701259260000},"page":"7408","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Enhanced Precision in Genioplasty: A Novel Intraoperative Spatial Repositioning Using Computer-Aided Design and Manufacturing Technology and a Holographic Mixed Reality Application"],"prefix":"10.3390","volume":"12","author":[{"given":"Masahide","family":"Koyachi","sequence":"first","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisuke","family":"Sugahara","sequence":"additional","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Tachizawa","sequence":"additional","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Nishiyama","sequence":"additional","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4717-533X","authenticated-orcid":false,"given":"Kento","family":"Odaka","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7059-8413","authenticated-orcid":false,"given":"Satoru","family":"Matsunaga","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maki","family":"Sugimoto","sequence":"additional","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"},{"name":"Innovation Lab, Teikyo University Okinaga Research Institute, 2-16-1 Hirakawacho Chiyoda-ku, Tokyo 102-0093, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chie","family":"Tachiki","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7695-1564","authenticated-orcid":false,"given":"Yasushi","family":"Nishii","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Katakura","sequence":"additional","affiliation":[{"name":"Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, 2-9-18 Kandamisaki-cho, Chiyoda-ku, Tokyo 101-0061, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,11,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.4067\/S0717-95022020000401120","article-title":"About Chin (Genioplasty) Surgery","volume":"38","author":"Marinho","year":"2020","journal-title":"Int. J. Morphol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1016\/S0030-4220(57)80063-2","article-title":"The surgical correction of mandibular prognathism and retrognathia with consideration of genioplasty","volume":"10","author":"Trauner","year":"1957","journal-title":"Oral Surg. Oral Med. Oral Pathol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"719985","DOI":"10.3389\/fsurg.2021.719985","article-title":"Development and Application of Digital Maxillofacial Surgery System Based on Mixed Reality Technology","volume":"8","author":"Yang","year":"2022","journal-title":"Front. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1186\/s12957-022-02677-0","article-title":"Digital Surgery Group versus Traditional Experience Group in Head and Neck Reconstruction: A Retrospective Controlled Study to Analyze Clinical Value and Time-Economic-Social Effect","volume":"20","author":"Sun","year":"2022","journal-title":"World J. Surg. Oncol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1097\/SCS.0000000000001528","article-title":"Combined Use of Rapid-Prototyping Model and Surgical Guide in Correction of Mandibular Asymmetry Malformation Patients with Normal Occlusal Relationship","volume":"26","author":"Xu","year":"2015","journal-title":"J. Craniofac. Surg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e85","DOI":"10.4317\/medoral.56145","article-title":"Genioplasty with Surgical Guide Using 3D-Printing Technology: A Systematic Review","volume":"12","author":"Oth","year":"2020","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s40902-022-00370-6","article-title":"Mixed Reality for Extraction of Maxillary Mesiodens","volume":"45","author":"Koyama","year":"2023","journal-title":"Maxillofac. Plast. Reconstr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/j.ijom.2020.09.026","article-title":"Accuracy of Le Fort I Osteotomy with Combined Computer-Aided Design\/Computer-Aided Manufacturing Technology and Mixed Reality","volume":"50","author":"Koyachi","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1049\/htl.2018.5072","article-title":"Augmented Reality in Computer-Assisted Interventions Based on Patient-Specific 3D Printed Reference","volume":"5","author":"Pascau","year":"2018","journal-title":"Healthc. Technol. Lett."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1016\/j.joms.2006.10.005","article-title":"Accuracy of the Computer-Aided Surgical Simulation (CASS) System in the Treatment of Patients with Complex Craniomaxillofacial Deformity: A Pilot Study","volume":"65","author":"Xia","year":"2007","journal-title":"J. Oral Maxillofac. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1055\/s-0035-1564716","article-title":"Navigation in Orthognathic Surgery: 3D Accuracy","volume":"31","author":"Badiali","year":"2015","journal-title":"Facial Plast. Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jcms.2020.05.003","article-title":"Accuracy of Laser-Melted Patient-Specific Implants in Genioplasty\u2014A Three-Dimensional Retrospective Study","volume":"48","author":"Ristow","year":"2020","journal-title":"J. Cranio-Maxillofac. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1097\/SCS.0000000000007074","article-title":"The Pyramid Chin Augmentation: A New Technique","volume":"32","author":"Ramieri","year":"2021","journal-title":"J. Craniofacial Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1055\/s-0033-1357113","article-title":"Aesthetic Alteration of the Chin","volume":"27","author":"Lee","year":"2013","journal-title":"Semin. Plast. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.ijom.2019.06.023","article-title":"Precision of Orthognathic Digital Plan Transfer Using Patient-Specific Cutting Guides and Osteosynthesis versus Mixed Analogue\u2013Digitally Planned Surgery: A Randomized Controlled Clinical Trial","volume":"49","author":"Hanafy","year":"2019","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.bjps.2022.02.055","article-title":"Effect of a Digital Guide on the Positional Accuracy of Intermaxillary Fixation Screw Implantation in Orthognathic Surgery","volume":"75","author":"Cui","year":"2022","journal-title":"J. Plast. Reconstr. Aesthetic Surg."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Kim, J.-W., Kim, J.-C., Jeong, C.-G., Cheon, K.-J., Cho, S.-W., Park, I.-Y., and Yang, B.-E. (2019). The Accuracy and Stability of the Maxillary Position after Orthognathic Surgery Using a Novel Computer-Aided Surgical Simulation System. BMC Oral Health, 19.","DOI":"10.1186\/s12903-019-0711-y"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/j.ijom.2019.06.017","article-title":"The Use of Patient-Specific Implants in Genioplasty and Its Clinical Accuracy: A Preliminary Study","volume":"49","author":"Li","year":"2020","journal-title":"Int. J. Oral Maxillofac. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2187","DOI":"10.21037\/qims-20-597","article-title":"Mixed Reality and Three Dimensional Printed Models for Resection of Maxillary Tumor: A Case Report","volume":"11","author":"Sugahara","year":"2021","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1007\/s10278-022-00609-8","article-title":"A Dedicated Tool for Presurgical Mapping of Brain Tumors and Mixed-Reality Navigation During Neurosurgery","volume":"35","author":"Chiacchiaretta","year":"2022","journal-title":"J. Digit. Imaging"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Pose-D\u00edez-de-la-Lastra, A., Moreta-Martinez, R., Garc\u00eda-Sevilla, M., Garc\u00eda-Mato, D., Calvo-Haro, J.A., Mediavilla-Santos, L., P\u00e9rez-Ma\u00f1anes, R., von Haxthausen, F., and Pascau, J. (2022). HoloLens 1 vs. HoloLens 2: Improvements in the New Model for Orthopedic Oncological Interventions. Sensors, 22.","DOI":"10.3390\/s22134915"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Palumbo, A. (2022). Microsoft HoloLens 2 in Medical and Healthcare Context: State of the Art and Future Prospects. Sensors, 22.","DOI":"10.3390\/s22207709"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7408\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:33:44Z","timestamp":1760132024000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/23\/7408"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,29]]},"references-count":22,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["jcm12237408"],"URL":"https:\/\/doi.org\/10.3390\/jcm12237408","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,29]]}}}