前期研究開發的正顎手術計畫專用導航咬合器系統—Nart(Navigational Articulator)，利用實體牙模與光學追蹤裝置追蹤正顎手術計畫顎骨位置，利用最佳對稱面(Optimal symmetry plane; OSP)提供對稱度、咬合與測顱數據上下顎骨，至今人體臨床試驗案例已超過百例。本研究開發與市售軟體雷同功能的虛擬正顎手術計畫軟體，提供使用者制定正顎手術計畫，量化比對與Nart產出的手術計畫下顎輪廓的對稱度。在輪廓對稱度的計算上，本研究提出精準度較優的影像像素分析量化方法，以統計檢定探討Nart計劃與虛擬手術計畫兩者下顎輪廓的對稱度上是否有顯著性差異。
虛擬手術計畫系統能提供使用者最佳對稱面或是自訂對稱面作為手術計畫參考，以因應不同程度的顏顎骨不對稱受試者。相較於Nart計劃的準備工作24小時，虛擬計畫的前置作業時間約需9小時。臨床試驗招募14名需正顎手術受試者，排除一名以自定義對稱面的受試者，13名受試者分別以兩系統的正顎手術計畫下顎骨的正面與正俯視面進行輪廓對稱度分析，目前統計結果顯示正面視角下有四項對稱量化指標有顯著差異，而正俯視面下所有的對稱量化指標均無顯著差異。由於臨床試驗樣本數較少，後續研究將繼續蒐集足夠的樣本數使統計分析結果更有可信度。

Nart (Navigational Articulator), a articulator tracking system of surgical planning for orthognathic surgery developed in our previous study. The system tracks the movements of both upper and the lower dental plasters of the subject to reveal current status between midface and lower jaw. Nart system provides an OSP (Optimal Symmetry Plane) methodology to quantify several symmetry indexes, real-time tracking the occlusion relationship, and illustrate the outcomes of cephalometry. Aim of our study is to evaluate the symmetry between Nart and computer-aided planning system. Therefore, we have developed a computerized surgical planning system, which is similar to commercial available surgical planning software, names VOSP (Virtual Optimal Symmetry Planning). In order to evaluate the symmetry situation of the plannings, we purposed an image-based method to quantify the symmetry status of mandibular contour. Statistical analysis was applied to assess the statistical significance of symmetry in surgical plans made by Nart and virtual planning system.

The developed virtual planning system allows users to use original OSP or setup landmark-based median plane as a reference plane. The pre-processing time for Nart and virtual planning systems are 24 and 9 hours, respectively. In the in Vivo experiment, we have recruited 14 subjects who was diagnosed facial asymmetry and have taken the orthognathic surgery but only 13 patients were suitable for statistical analysis. The same presurgery computer tomography image were used to applied both Nart and virtual planning. Outcomes of statistical analysis showed that symmetry of mandibular contour between two systems is significant difference in frontal view.There is no significant difference in frontal downward inclined view. The outcomes of statistical analysis may not be reliable due to the small amount of sample size. More data need to be collected in the near future.

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