3/4/25, conseil des ministres, [M. Anatole] de Monzie [quittant l'Elysée] : [photographie de presse] / [Agence Rol]

Référence bibliographique : Rol, 99651Appartient à l’ensemble documentaire : Pho20RolImage de press

First-in-man application of a cold ablation robot guided laser osteotome in midface osteotomies

The aim of the study was to assess the clinical applicability of robot guided laser osteotomy for clinical application. This is the initial report on 14 consecutive patients requiring an orthognathic procedure with a midface osteotomy (no restrictions made on the surgical indication itself) who have undergone surgery by means of the Cold Ablation Laser Osteotome CARLO (R) (AOT Advanced Osteotomy Tools, Basle, Switzerland), which is an integrated system, functionally comprising: an Er:YAG laser source, intended to perform osteotomies using cold laser ablation, a robot arm that controls the position of the laser source, an optical tracking device that provides a continuous and accurate measurement of the position of the laser source and of reference elements attached to instruments or bones, a navigation system (software) that is able to read preoperatively defined planned osteotomies, and - under the control of a surgeon - performs the planned osteotomies. Safety was assessed by unimpaired postoperative healing and the absence of device related injuries; performance was assessed as ability to cut the maxilla along the preoperatively planned cutting path with a rage of accuracy of 2mm. Cold ablation robot-guided laser osteotomy could successfully be performed in 14 consecutive patients. No intraoperative complications or technical failure occurred. All osteotomies were within an average deviation of 0.80 mm (+/- 0.26 mm) of the virtually preplanned location. The registration procedure to set up the robot at the beginning of the operation required a mean time of 4.6 min (+/- 5.3min). In this report we describe the effective and successful routine use of Cold ablation robot-guided laser osteotomy in an actual clinical setting. It is a promising technical innovation that has the potential to set new standards for accuracy and safety in orthognathic surgery. (C) 2021 The Authors. Published by Elsevier Ltd on behalf of European Association for Cranio-Maxillo-Facial Surgery

Scientific Reports / Changes of temporomandibular joint position after surgery first orthognathic treatment concept

Orthognathic surgery treatment (OGS) after orthodontic treatment of dentofacial deformities is a widely performed procedure, often accompanied by a bilateral sagittal split osteotomy (BSSO). Positioning of the condyle during this procedure is a crucial step for achieving optimal functional and anatomical results. Intraoperatively poorly positioned condyles can have a negative effect on the postoperative result and the patients well-being. Changes of the condylar position during OGS Procedures and its effects on the temporomandibular joint in orthognathic surgical interventions (OGS) are subject of scientific discussions. However, up to date, no study has investigated the role of condyle position in the surgery first treatment concept. The aim of this study was to investigate the influence of OGS on the three-dimensional position of the condyle in the joint in a surgery first treatment concept without positioning device and to record the change in position quantitatively and qualitatively. Analysis of our data indicated that OGS in surgery first treatment concept has no significant effect on the position of the condyle and the anatomy of the temporomandibular joint.(VLID)492859

Perception of aesthetics and personality traits in orthognathic surgery patients: A comparison of still and moving images

<div><p>It is common in practicing orthognathic surgery to evaluate faces with retruded or protruded chins (dysgnathic faces) using photographs. Because motion may alter how the face is perceived, we investigated the perception of faces presented via photographs and videos. Two hundred naïve raters (lay persons, without maxillo facial surgery background) evaluated 12 subjects with varying chin anatomy [so-called skeletal Class I (normal chin), Class II (retruded chin), and Class III (protruded chin)]. Starting from eight traits, with Factor analysis we found a two-Factor solution, i.e. an "aesthetics associated traits cluster" and a Factor "personality traits cluster" which appeared to be uncorrelated. Internal consistency of the Factors found for photographs and videos was excellent. Generally, female raters delivered better ratings than males, but the effect sizes were small. We analyzed differences and the respective effect magnitude between photograph and video perception. For each skeletal class the aesthetics associated dimensions were rated similarly between photographs and video clips. In contrast, specific personality traits were rated differently. Differences in the class-specific personality traits seen on photographs were "smoothed" in the assessment of videos, which implies that photos enhance stereotypes commonly attributed to a retruded or protruded chin.</p></div

Standardized stimuli presentation of photographs.

<p>The still faces were presented to the raters from both sides and from the front simultaneously. The rotation during the video presentation was as indicated by the arrow: starting from the left profile, and slowly turned over to the right.</p

Cold ablation robot-guided laser osteotome (CARLO®) : from bench to bedside

Background: In order to overcome the geometrical and physical limitations of conventional rotating and piezosurgery instruments used to perform bone osteotomies, as well as the difficulties in translating digital planning to the operating room, a stand-alone robot-guided laser system has been developed by Advanced Osteotomy Tools, a Swiss start-up company. We present our experiences of the first-in-man use of the Cold Ablation Robot-guided Laser Osteotome (CARLO(R)). Methods: The CARLO(R) device employs a stand-alone 2.94-mu m erbium-doped yttrium aluminum garnet (Er:YAG) laser mounted on a robotic arm. A 19-year-old patient provided informed consent to undergo bimaxillary orthognathic surgery. A linear Le Fort I midface osteotomy was digitally planned and transferred to the CARLO(R) device. The linear part of the Le Fort I osteotomy was performed autonomously by the CARLO(R) device under direct visual control. All pre-, intra-, and postoperative technical difficulties and safety issues were documented. Accuracy was analyzed by superimposing pre- and postoperative computed tomography images. Results: The CARLO(R) device performed the linear osteotomy without any technical or safety issues. There was a maximum difference of 0.8 mm between the planned and performed osteotomies, with a root-mean-square error of 1.0 mm. The patient showed normal postoperative healing with no complications. Conclusion: The newly developed stand-alone CARLO(R) device could be a useful alternative to conventional burs, drills, and piezosurgery instruments for performing osteotomies. However, the technical workflow concerning the positioning and fixation of the target marker and the implementation of active depth control still need to be improved. Further research to assess safety and accuracy is also necessary, especially at osteotomy sites where direct visual control is not possible. Finally, cost-effectiveness analysis comparing the use of the CARLO(R) device with gold-standard surgery protocols will help to define the role of the CARLO(R) device in the surgical landscape

Results of GLM for repeated measures for Factor I (Aesthetics associated traits) and for Factor II (Personality).

<p>Note that for the Aesthetics Traits Cluster Factor (A) there is almost no difference between photo and video in any class. Within the Personality Traits Cluster Factor (B) the photo ratings received higher scores in Class II and lower scores in Class III, which implies that photos enhance stereotypes commonly attributed to a retruded (Class II) or protruded (Class III) chin.</p

Gender-related differences.

<p>Ratings for photographs and video clips, for Factor I (aesthetics) and Factor II (personality).</p

Stimuli, model persons with Class I (norm), Class II (retruded chin), and Class III (protruded chin).

<p>The persons wore no make-up, the hair was covered by a surgeons cap, to minimize distractions from the face anatomy.</p