1
|
Msallem B, Veronesi L, Beyer M, Halbeisen FS, Maintz M, Franke A, Korn P, Dragu A, Thieringer FM. Evaluation of the Dimensional Accuracy of Robot-Guided Laser Osteotomy in Reconstruction with Patient-Specific Implants-An Accuracy Study of Digital High-Tech Procedures. J Clin Med 2024; 13:3594. [PMID: 38930123 DOI: 10.3390/jcm13123594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 06/14/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024] Open
Abstract
Background/Objective: With the rapid advancement in surgical technologies, new workflows for mandibular reconstruction are constantly being evaluated. Cutting guides are extensively employed for defining osteotomy planes but are prone to errors during fabrication and positioning. A virtually defined osteotomy plane and drilling holes in robotic surgery minimize potential sources of error and yield highly accurate outcomes. Methods: Ten mandibular replicas were evaluated after cutting-guided saw osteotomy and robot-guided laser osteotomy following reconstruction with patient-specific implants. The descriptive data analysis summarizes the mean, standard deviation (SD), median, minimum, maximum, and root mean square (RMS) values of the surface comparison for 3D printed models regarding trueness and precision. Results: The saw group had a median trueness RMS value of 2.0 mm (SD ± 1.7) and a precision of 1.6 mm (SD ± 1.4). The laser group had a median trueness RMS value of 1.2 mm (SD ± 1.1) and an equal precision of 1.6 mm (SD ± 1.4). These results indicate that robot-guided laser osteotomies have a comparable accuracy to cutting-guided saw osteotomies, even though there was a lack of statistical significance. Conclusions: Despite the limited sample size, this digital high-tech procedure has been shown to be potentially equivalent to the conventional osteotomy method. Robotic surgery and laser osteotomy offers enormous advantages, as they enable the seamless integration of precise virtual preoperative planning and exact execution in the human body, eliminating the need for surgical guides in the future.
Collapse
Affiliation(s)
- Bilal Msallem
- University Center for Orthopedics, Trauma and Plastic Surgery, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, DE-01307 Dresden, Germany
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
| | - Lara Veronesi
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Michel Beyer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Florian S Halbeisen
- Surgical Outcome Research Center, Department of Clinical Research, University of Basel c/o University Hospital of Basel, CH-4001 Basel, Switzerland
| | - Michaela Maintz
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
- Institute for Medical Engineering and Medical Informatics, University of Applied Sciences and Arts Northwestern Switzerland, CH-4132 Muttenz, Switzerland
| | - Adrian Franke
- Department of Oral and Maxillofacial Surgery, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, DE-01307 Dresden, Germany
| | - Paula Korn
- Department of Oral and Maxillofacial Surgery, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, DE-01307 Dresden, Germany
| | - Adrian Dragu
- University Center for Orthopedics, Trauma and Plastic Surgery, Medical Faculty and University Hospital Carl Gustav Carus, Technische Universität Dresden, DE-01307 Dresden, Germany
| | - Florian M Thieringer
- Medical Additive Manufacturing Research Group (Swiss MAM), Department of Biomedical Engineering, University of Basel, CH-4123 Allschwil, Switzerland
- Clinic of Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland
| |
Collapse
|
2
|
Ganta GK, Mosca RC, Varsani R, Murthy VR, Cheruvu K, Lu M, Arany PR. Automation in Dentistry with Mechanical Drills and Lasers for Implant Osteotomy: A Narrative-Scoping Review. Dent J (Basel) 2023; 12:8. [PMID: 38248216 PMCID: PMC10814723 DOI: 10.3390/dj12010008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 12/11/2023] [Accepted: 12/28/2023] [Indexed: 01/23/2024] Open
Abstract
The popularity of implants is increasing with the aging population requiring oral-dental rehabilitation. There are several critical steps in the implant workflow, including case selection, implant design, surgical procedure, biological tissue responses, and functional restoration. Among these steps, surgical osteotomy procedures are a crucial determinant of clinical success. This brief review was aimed at outlining the current state of the field in automation-assisted implant surgical osteotomy technologies. A broad search of the literature was performed to identify current literature. The results are outlined in three broad categories: semi-automated static (image-guided) or dynamic (navigation-assisted) systems, and fully-automated robotic systems. As well as the current mechanical rotary approaches, the literature supporting the use of lasers in further refinement of these approaches is reviewed. The advantages and limitations of adopting autonomous technologies in practical clinical dental practices are discussed. In summary, advances in clinical technologies enable improved precision and efficacious clinical outcomes with implant dentistry. Hard-tissue lasers offer further advancements in precision, improved biological responses, and favorable clinical outcomes that require further investigation.
Collapse
Affiliation(s)
- Gopala Krishna Ganta
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
- Intercare Community Health Network, Bangor, MI 49013, USA
| | - Rodrigo Crespo Mosca
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Ridham Varsani
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Venkata Ramana Murthy
- Department of Maxillofacial Surgery, Anil Nirukonda Dental College, Visakhapatnam 531162, India
| | - Kamala Cheruvu
- Department of Orthodontics, Gandhi Institute of Technology and Management Dental College, Visakhapatnam 530045, India
| | - Michael Lu
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| | - Praveen R. Arany
- Oral Biology, Biomedical Engineering & Surgery, University at Buffalo, Buffalo, NY 14214, USA
| |
Collapse
|