Real-Time Marker-Free Patient Registration and Image-Based Navigation Using Stereovision for Dental Surgery

Development of a dental handpiece angle correction device

Background

Preparation of a uniform angle of walls is essential for making an ideal convergence angle in fixed prosthodontics. We developed a de novo detachable angle-correction apparatus for dental handpiece drills that could help the ideal tooth preparation.

Methods

We utilized a gyro sensor to measure the angular velocities to calculate the slope of an object by integrating the values, acceleration sensor to calculate the slope of an object by measuring the acceleration relative to gravity, and Kalman filter algorithm. Converting the angulation of the handpiece body to its drill part could be performed by a specific matrix formulation set on two reference points (2° and 6°). A flexible printed circuit board was used to minimize the size of the device. For convergence angle investigation, 16 volunteers were divided randomly into two groups for performing tooth preparation on a mandibular first molar resin tooth. All abutments were scanned by a 3D scanner (D700^®, 3Shape Co., Japan), the convergence angle and tooth axis deviation were analyzed by a CAD program (SolidWorks 2013^®, Dassault Systems Co., USA) with statistical analysis by Wilcoxon signed-rank test (α = 0.05) using SPSS statistical software (Version 16.0, SPSS Inc.).

Results

This device successfully maintained the stable zero point (less than 1° deviation) at different angles (0°, 30°, 60°, 80°) for the first 30 min. In single tooth preparation, without this apparatus, the average bucco-lingual convergence angle was 20.26° (SD 7.85), and the average mesio–distal (MD) convergence angle was 17.88° (SD 7.64). However, the use of this apparatus improved the average BL convergence angle to 13.21° (SD 4.77) and the average MD convergence angle to 10.79° (SD 4.48). The angle correction device showed a statistically significant effect on reducing the convergence angle of both directions regardless of the order of the directions.

Conclusions

The angle correction device developed in this study is capable of guiding practitioners with high accuracy comparable to that of commercial navigation surgery. The volume of the angle correction device is much smaller than that of any other commercial navigation surgery system. This device is expected to be widely utilized in various fields of orofacial surgery.

Video see-through augmented reality for oral and maxillofacial surgery

BACKGROUND

Oral and maxillofacial surgery has not been benefitting from image guidance techniques owing to the limitations in image registration.

METHODS

A real-time markerless image registration method is proposed by integrating a shape matching method into a 2D tracking framework. The image registration is performed by matching the patient's teeth model with intraoperative video to obtain its pose. The resulting pose is used to overlay relevant models from the same CT space on the camera video for augmented reality.

RESULTS

The proposed system was evaluated on mandible/maxilla phantoms, a volunteer and clinical data. Experimental results show that the target overlay error is about 1 mm, and the frame rate of registration update yields 3-5 frames per second with a 4 K camera.

CONCLUSIONS

The significance of this work lies in its simplicity in clinical setting and the seamless integration into the current medical procedure with satisfactory response time and overlay accuracy. Copyright © 2016 John Wiley & Sons, Ltd.