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Al Hamad KQ, Said KN, Engelschalk M, Matoug-Elwerfelli M, Gupta N, Eric J, Ali SA, Ali K, Daas H, Abu Alhaija ES. Taxonomic discordance of immersive realities in dentistry: A systematic scoping review. J Dent 2024; 146:105058. [PMID: 38729286 DOI: 10.1016/j.jdent.2024.105058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/04/2024] [Accepted: 05/07/2024] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES This review aimed to map taxonomy frameworks, descriptions, and applications of immersive technologies in the dental literature. DATA The Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines was followed, and the protocol was registered at open science framework platform (https://doi.org/10.17605/OSF.IO/H6N8M). SOURCES Systematic search was conducted in MEDLINE (via PubMed), Scopus, and Cochrane Library databases, and complemented by manual search. STUDY SELECTION A total of 84 articles were included, with 81 % between 2019 and 2023. Most studies were experimental (62 %), including education (25 %), protocol feasibility (20 %), in vitro (11 %), and cadaver (6 %). Other study types included clinical report/technique article (24 %), clinical study (9 %), technical note/tip to reader (4 %), and randomized controlled trial (1 %). Three-quarters of the included studies were published in oral and maxillofacial surgery (38 %), dental education (26 %), and implant (12 %) disciplines. Methods of display included head mounted display device (HMD) (55 %), see through screen (32 %), 2D screen display (11 %), and projector display (2 %). Descriptions of immersive realities were fragmented and inconsistent with lack of clear taxonomy framework for the umbrella and the subset terms including virtual reality (VR), augmented reality (AR), mixed reality (MR), augmented virtuality (AV), extended reality, and X reality. CONCLUSIONS Immersive reality applications in dentistry are gaining popularity with a notable surge in the number of publications in the last 5 years. Ambiguities are apparent in the descriptions of immersive realities. A taxonomy framework based on method of display (full or partial) and reality class (VR, AR, or MR) is proposed. CLINICAL SIGNIFICANCE Understanding different reality classes can be perplexing due to their blurred boundaries and conceptual overlapping. Immersive technologies offer novel educational and clinical applications. This domain is fast developing. With the current fragmented and inconsistent terminologies, a comprehensive taxonomy framework is necessary.
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Affiliation(s)
- Khaled Q Al Hamad
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar.
| | - Khalid N Said
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar
| | - Marcus Engelschalk
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Germany
| | | | - Nidhi Gupta
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Jelena Eric
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Shaymaa A Ali
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar; Hamad Medical Corporation, Doha, Qatar
| | - Kamran Ali
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hanin Daas
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
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Rieder M, Remschmidt B, Gsaxner C, Gaessler J, Payer M, Zemann W, Wallner J. Augmented Reality-Guided Extraction of Fully Impacted Lower Third Molars Based on Maxillofacial CBCT Scans. Bioengineering (Basel) 2024; 11:625. [PMID: 38927861 PMCID: PMC11200966 DOI: 10.3390/bioengineering11060625] [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: 05/15/2024] [Revised: 06/07/2024] [Accepted: 06/16/2024] [Indexed: 06/28/2024] Open
Abstract
(1) Background: This study aimed to integrate an augmented reality (AR) image-guided surgery (IGS) system, based on preoperative cone beam computed tomography (CBCT) scans, into clinical practice. (2) Methods: In preclinical and clinical surgical setups, an AR-guided visualization system based on Microsoft's HoloLens 2 was assessed for complex lower third molar (LTM) extractions. In this study, the system's potential intraoperative feasibility and usability is described first. Preparation and operating times for each procedure were measured, as well as the system's usability, using the System Usability Scale (SUS). (3) Results: A total of six LTMs (n = 6) were analyzed, two extracted from human cadaver head specimens (n = 2) and four from clinical patients (n = 4). The average preparation time was 166 ± 44 s, while the operation time averaged 21 ± 5.9 min. The overall mean SUS score was 79.1 ± 9.3. When analyzed separately, the usability score categorized the AR-guidance system as "good" in clinical patients and "best imaginable" in human cadaver head procedures. (4) Conclusions: This translational study analyzed the first successful and functionally stable application of the HoloLens technology for complex LTM extraction in clinical patients. Further research is needed to refine the technology's integration into clinical practice to improve patient outcomes.
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Affiliation(s)
- Marcus Rieder
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
| | - Bernhard Remschmidt
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
| | - Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria
| | - Jan Gaessler
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Wolfgang Zemann
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
| | - Juergen Wallner
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
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Martinho FC, Qadir SJ, Griffin IL, Melo MAS, Fay GG. Augmented Reality Head-Mounted Device and Dynamic Navigation System for Postremoval in Maxillary Molars. J Endod 2024; 50:844-851. [PMID: 38369102 DOI: 10.1016/j.joen.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 01/20/2024] [Accepted: 02/07/2024] [Indexed: 02/20/2024]
Abstract
INTRODUCTION This study evaluates the feasibility of an augmented reality (AR) head-mounted device (HMD) displaying a dynamic navigation system (DNS) in the surgical site for fiber postremoval in maxillary molars and compares it to the DNS technique. METHODS Fifty maxillary first molars were divided into 2 groups: AR HMD + DNS (n = 25) and DNS (n = 25). The palatal canal was restored with RelyX fiber post (3M ESPE) luted with RelyX Unicem (3M ESPE). A core buildup was performed using Paracore (Coltene/Whaledent). Cone beam computed tomography (CBCT) scans were taken before and after postremoval. The drilling trajectory and depth were planned under X-guide software (X-Nav Technologies, Lansdale, PA). For the AR HMD + DNS group, the AR HMD (Microsoft HoloLens 2) displayed the DNS in the surgical site. The three dimensional (3D) deviations (Global coronal deviation [GCD] and global apical deviation [GAD]) and angular deflection (AD) were calculated. The number of mishaps and operating time were recorded. RESULTS Fiber post was removed from all samples (50/50). The AR HMD + DNS was more accurate than DNS, showing significantly lower GCD and GAD deviations and AD (P < .05). No mishap was detected. The AR HMD + DNS was as efficient in time as DNS (P > .05). CONCLUSIONS Within the limitations of this in vitro study, the AR HMD can safely display DNS in the surgical site for fiber post-removal in maxillary molars. AR HMD improved the DNS accuracy. Both AR HMD + DNS and DNS were time-efficient for fiber postremoval in maxillary molars.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Syed J Qadir
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Mary Anne S Melo
- Division of Operative Dentistry, Department of General Dentistry, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Guadalupe G Fay
- Division of Prosthodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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Engelschalk M, Al Hamad KQ, Mangano R, Smeets R, Molnar TF. Dental implant placement with immersive technologies: A preliminary clinical report of augmented and mixed reality applications. J Prosthet Dent 2024:S0022-3913(24)00141-0. [PMID: 38480015 DOI: 10.1016/j.prosdent.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 04/21/2024]
Abstract
A preliminary clinical report of implant placements with 2 immersive reality technologies is described: augmented reality with head mounted display and mixed reality with a tablet PC. Both immersive realities are promising and could facilitate innovative dental applications. However, mixed reality requires further development for clinical optimization.
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Affiliation(s)
- Marcus Engelschalk
- Researcher, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; and Private practice, Munich, Germany
| | - Khaled Q Al Hamad
- Professor, College of Dental Medicine, Qatar University, QU Health, Doha, Qatar.
| | | | - Ralf Smeets
- Professor, Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tamás F Molnar
- Professor, Medical Skill and Innovation Centre, Department of Operational Medicine, Medical School, University of Pécs, Pécs, Hungary
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Bochet Q, Raoul G, Lauwers L, Nicot R. Augmented reality in implantology: Virtual surgical checklist and augmented implant placement. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024:101813. [PMID: 38452901 DOI: 10.1016/j.jormas.2024.101813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 02/17/2024] [Accepted: 03/05/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES Aim of the present study was to create a pedagogical checklist for implant surgical protocol with an augmented reality (AR) guided freehand surgery to inexperienced surgeons using a head mounted display (HMD) with tracking. METHODS The anatomical model of a patient with two missing mandibular teeth requiring conventional single-tooth implants was selected. The computed tomography (CT) scans were extracted and imported into segmentation and implant planning software. A Patient-specific dental splint through an intermediate strut, supported 3D-printed QR code. A checklist was generated to guide surgical procedure. After tracking, the AR-HMD projects the virtual pre-surgical plan (inferior alveolar nerve (IAN), implant axis, implant location) onto the real 3D-printed anatomical models. The entire drilling sequence was based on the manufacturer's recommendations, on 3D-printed anatomical models. After the implant surgical procedure, CT of the 3D-printed models was performed to compare the actual and simulated implant placements. All procedures in the study were performed in accordance with the Declaration of Helsinki. RESULTS In total, two implants were placed in a 3D-printed anatomical model of a female patient who required implant rehabilitation for dental agenesis at the second mandibular premolar positions (#35 and #45). Superimposition of the actual and simulated implants showed high concordance between them. CONCLUSION AR in education offers crucial surgical information for novice surgeons in real time. However, the benefits provided by AR in clinical and educational implantology must be demonstrated in other studies involving a larger number of patients, surgeons and apprentices.
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Affiliation(s)
- Quentin Bochet
- Univ. Lille, CHU Lille, Department of Oral and Maxillofacial Surgery, Lille F-59000, France
| | - Gwénaël Raoul
- Univ. Lille, CHU Lille, INSERM, Department of Oral and Maxillo-Facial Surgery, U1008 - Advanced Drug Delivery Systems, Lille F-59000, France
| | - Ludovic Lauwers
- Univ. Lille, CHU Lille, Department of Oral and Maxillofacial Surgery, URL 2694 - METRICS, Lille F-59000, France
| | - Romain Nicot
- Univ. Lille, CHU Lille, INSERM, Department of Oral and Maxillo-Facial Surgery, U1008 - Advanced Drug Delivery Systems, Lille F-59000, France; CNRS, Centrale Lille, Univ. Lille, UMR 9013 - LaMcube - Laboratoire de Mécanique, Multiphysique, Multiéchelle, Lille F-59000, France.
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Parekar D, Selvaganesh S, Nesappan T. Comparative Evaluation of Accuracy of Adjacent Parallel Implant Placements Between Dynamic Navigation and Static Guide: A Prospective Study. Cureus 2024; 16:e57331. [PMID: 38694417 PMCID: PMC11061662 DOI: 10.7759/cureus.57331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/31/2024] [Indexed: 05/04/2024] Open
Abstract
Aim The study aims to compare the accuracy of dynamic navigation (DN) and static guides (SGs) for simultaneous adjacent parallel placement of implants, the time taken for the surgery, and the ease of handling the instruments. Materials and methods This prospective trial was carried out at the Department of Implantology of Saveetha Dental College from October 2022 to February 2023. A total of 20 patients who needed simultaneous adjacent dental implants were allocated randomly into two groups: Group 1 SG surgery and Group 2 DN surgery. Forty implants were placed, 20 under DN and 20 under SG. Bucco-lingual displacement, apico-coronal displacement, mesiodistal displacement, and mesiodistal angulation were compared between the two groups. The patients' data in both groups were evaluated by operating surgeons along with the surgical time taken and the ease of handling of instruments. Results The 20 patients who underwent implant placement in the DN and SG groups all had adjacent missing teeth in posterior sites, including lower posteriors (70%) and upper posteriors (30%). There was improved precision in relation to the mesiodistal displacement and angulation of the anterior implant of the adjacent parallel implants. The mesiodistal displacement in Group 1 (SG) was 5.61 + 3.1 mm, which was higher than Group 2 (DN), which was 0.55 + 0.56 mm. The mesiodistal angulation was 3.1 + 2.9 degrees in Group 2 and 0.42 + 0.5 degrees in Group 1. The second implant had a significant difference (p < 0.005) in mesiodistal displacement, mesiodistal angulation, and bucco-lingual displacement. The difference between the intergroup surgical time (mean + SD) in Group 1 was 30 + 4.5 mins and in Group 2 was 60.7 + 10.1 mins, with p < 0.05 statistically significant. The comfort of the operator was better in the SG group. Conclusion Any digitally aided implant placement technique can improve placement accuracy but each has its downfalls. Achieving the highest levels of precision and long-lasting prosthetic results hinges on both the suitability of the chosen case and the expertise of the surgeon performing the implant placement.
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Affiliation(s)
- Dnyaneshwar Parekar
- Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Sahana Selvaganesh
- Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
| | - Thiyaneswaran Nesappan
- Prosthodontics and Implantology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, IND
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Yang X, Zhang Y, Chen X, Huang L, Qiu X. Limitations and Management of Dynamic Navigation System for Locating Calcified Canals Failure. J Endod 2024; 50:96-105. [PMID: 37890613 DOI: 10.1016/j.joen.2023.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023]
Abstract
Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and spatial location registration, the dynamic navigation technique uses an optical tracking system to guide the clinician to drill in real time according to the predesigned path until access to the canal is established. Several in vitro studies and case reports have shown that calcified canal location with dynamic navigation system (DNS) is more accurate and efficient, yet the technique has limitations. In 4 cases with 7 teeth, this work presents manipulation process and clinical outcomes of DNS helping in calcified canal location. We performed handpiece adaptation and elucidated the failure to locate the canals with DNS in 2 teeth, resulting in canal geometry alteration and canal path deviation. Subsequently, the more experienced endodontist located the canals by combining cone-beam computed tomographic imaging and dental operating microscopy. All patients were completely asymptomatic after treatment. At the 1-year follow-up visit, the bone healing of periapical lesions progressed well according to the periapical radiography or cone-beam computed tomographic imaging. These findings indicate that DNS is a promising technique for locating calcified canals; however, it needs to be refined before clinical use.
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Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
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Tao B, Fan X, Wang F, Chen X, Shen Y, Wu Y. Comparison of the accuracy of dental implant placement using dynamic and augmented reality-based dynamic navigation: An in vitro study. J Dent Sci 2024; 19:196-202. [PMID: 38303816 PMCID: PMC10829549 DOI: 10.1016/j.jds.2023.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 05/05/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Augmented reality has been gradually applied in dental implant surgery. However, whether the dynamic navigation system integrated with augmented reality technology will further improve the accuracy is still unknown. The purpose of this study is to investigate the accuracy of dental implant placement using dynamic navigation and augmented reality-based dynamic navigation systems. Materials and methods Thirty-two cone-beam CT (CBCT) scans from clinical patients were collected and used to generate 64 phantoms that were allocated to the augmented reality-based dynamic navigation (ARDN) group or the conventional dynamic navigation (DN) group. The primary outcomes were global coronal, apical and angular deviations, and they were measured after image fusion. A linear mixed model with a random intercept was used. A P value < 0.05 was considered to indicate statistical significance. Results A total of 242 dental implants were placed in two groups. The global coronal, apical and angular deviations of the ARDN and DN groups were 1.31 ± 0.67 mm vs. 1.18 ± 0.59 mm, 1.36 ± 0.67 mm vs. 1.39 ± 0.55 mm, and 3.72 ± 2.13° vs. 3.1 ± 1.56°, respectively. No significant differences were found with regard to coronal and apical deviations (P = 0.16 and 0.6, respectively), but the DN group had a significantly lower angular deviation than the ARDN group (P = 0.02). Conclusion The augmented reality-based dynamic navigation system yielded a similar accuracy to the conventional dynamic navigation system for dental implant placement in coronal and apical points, but the augmented reality-based dynamic navigation system yielded a higher angular deviation.
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Affiliation(s)
- Baoxin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xingqi Fan
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Wang
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yihan Shen
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, Shanghai, China
- National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Shanghai, China
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Takács A, Hardi E, Cavalcante BGN, Szabó B, Kispélyi B, Joób-Fancsaly Á, Mikulás K, Varga G, Hegyi P, Kivovics M. Advancing accuracy in guided implant placement: A comprehensive meta-analysis: Meta-Analysis evaluation of the accuracy of available implant placement Methods. J Dent 2023; 139:104748. [PMID: 37863173 DOI: 10.1016/j.jdent.2023.104748] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/22/2023] Open
Abstract
OBJECTIVES This meta-analysis aimed to determine the accuracy of currently available computer-assisted implant surgery (CAIS) modalities under in vitro conditions and investigate whether these novel techniques can achieve clinically acceptable accuracy. DATA In vitro studies comparing the postoperative implant position with the preoperative plan were included. Risk of bias was assessed using the Quality Assessment Tool For In Vitro Studies (QUIN Tool) and a sensitivity analysis was conducted using funnel plots. SOURCES A systematic search was performed on April 18, 2023, using the following three databases: MEDLINE (via PubMed), EMBASE, and Cochrane Central Register of Controlled Trials. No filters or restrictions were applied during the search. RESULTS A total of 5,894 studies were included following study selection. Robotic- and static CAIS (sCAIS) had the most accurate and clinically acceptable outcomes. sCAIS was further divided according to the guidance level. Among the sCAIS groups, fully guided implant placement had the greatest accuracy. Augmented reality-based CAIS (AR-based CAIS) had clinically acceptable results for all the outcomes except for apical global deviation. Dynamic CAIS (dCAIS) demonstrated clinically safe results, except for horizontal apical deviation. Freehand implant placement was associated with the greatest number of errors. CONCLUSIONS Fully guided sCAIS demonstrated the most predictable outcomes, whereas freehand sCAIS demonstrated the lowest accuracy. AR-based and robotic CAIS may be promising alternatives. CLINICAL SIGNIFICANCE To our knowledge, this is the first meta-analysis to evaluate the accuracy of robotic CAIS and investigate the accuracy of various CAIS modalities.
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Affiliation(s)
- Anna Takács
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Eszter Hardi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Bianca Golzio Navarro Cavalcante
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary
| | - Barbara Kispélyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Árpád Joób-Fancsaly
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oro-Maxillofacial Surgery and Stomatology, Semmelweis University, Mária utca 52. 1085 Budapest, Hungary
| | - Krisztina Mikulás
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Prosthodontics, Semmelweis University, Szentkirályi utca 47. 1088 Budapest, Hungary
| | - Gábor Varga
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Department of Oral Biology, Semmelweis University, Nagyvárad tér 4. 1089 Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary; Institute for Translational Medicine, Szentágothai Research Centre, Medical School, University of Pécs, Szigeti út 12. 7624 Pécs, Hungary; Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Városmajor utca 68. 1122 Budapest, Hungary
| | - Márton Kivovics
- Department of Community Dentistry, Semmelweis University, Szentkirályi utca 40. 1088 Budapest, Hungary; Centre for Translational Medicine, Semmelweis University, Üllői út 26. 1085 Budapest, Hungary.
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González-Rueda JR, Galparsoro-Catalán A, de Paz-Hermoso VM, Riad-Deglow E, Zubizarreta-Macho Á, Pato-Mourelo J, Hernández-Montero S, Montero-Martín J. Accuracy of zygomatic dental implant placement using computer-aided static and dynamic navigation systems compared with a mixed reality appliance. An in vitro study. J Clin Exp Dent 2023; 15:e1035-e1044. [PMID: 38186921 PMCID: PMC10767737 DOI: 10.4317/jced.61097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/14/2023] [Indexed: 01/09/2024] Open
Abstract
Background Analyze and compare the accuracy of zygomatic dental implant placement carried out using a static navigation surgery, a dynamic navigation surgery and an augmented reality appliance. Material and Methods Eighty (80) zygomatic dental implants were randomly assigned to one of four study groups: A: static navigation implant surgery (n = 20) (GI); B: dynamic navigation implant surgery (n = 20) (NI); C: augmented reality appliance implant placement (n = 20) (ARI) and D: free hand technique (n = 20) (FHI). A preoperative cone-beam computed tomography (CBCT) scan of the existing situation was performed to plan the surgical approach for the computer assisted implant surgery study groups. Four zygomatic dental implants were placed in anatomical-based polyurethane models (n = 20) manufactured by stereolithography, and a postoperative CBCT scan was taken. Subsequently, the preoperative planning and postoperative CBCT scans were uploaded to dental implant software to analyze the coronal global, apical global, and angular deviations. Results were analyzed using linear regression models with repeated measures to assess the differences according to the group, according to the position, and the interaction between both variables. If statistically significant differences were detected, 2-to-2 comparisons were made between the groups/positions. Results The results did not show statistically significant differences between the coronal global deviations of GI (5.54 ± 1.72 mm), NI (5.43 ± 2.13 mm), ARI (5.64 ± 1.11 mm) and FHI (4.75 ± 1.58 mm). However, showed statistically significant differences between the apical global deviations of FHI (3.20 ± 1.45 mm) and NI (4.92 ± 1.89 mm) (p = 0.0078), FHI and GI (5.33 ± 2.14 mm) (p = 0.0005) and FHI and ARI (4.88 ± 1.54 mm) (p = 0.0132). In addition, the results showed also statistically significant differences between the angular deviations of FHI (8.47º ± 4.40º) and NI (7.36º ± 4.12º) (p = 0.0086) and between GI (5.30º ± 2.80º) and ARI (9.60º ± 4.25º) (p = 0.0005). Conclusions Free-hand technique provides greater accuracy of zygomatic dental implant placement than computer-assisted implant surgical techniques, and zygomatic dental implants placed in the anterior region are more accurate than in the posterior region. However, it is an in vitro study and further clinical studies must be conducted to extrapolate the results to the clinical setting. Key words:Implantology, computer assisted implant surgery, image-guided surgery, augmented reality, navigation surgery, zygomatic implants.
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Affiliation(s)
- Juan-Ramón González-Rueda
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
| | - Agustín Galparsoro-Catalán
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
| | | | - Elena Riad-Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Jesús Pato-Mourelo
- Department of Surgery, Faculty of Dentistry, University of Navarra, 31009 Pamplona (Navarra), Spain
| | - Sofía Hernández-Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X el Sabio University, 28691 Madrid, Spain
| | - Javier Montero-Martín
- Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
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11
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Fan X, Tao B, Tu P, Shen Y, Wu Y, Chen X. A novel mixed reality-guided dental implant placement navigation system based on virtual-actual registration. Comput Biol Med 2023; 166:107560. [PMID: 37847946 DOI: 10.1016/j.compbiomed.2023.107560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 09/14/2023] [Accepted: 10/10/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUNDS The key to successful dental implant surgery is to place the implants accurately along the pre-operative planned paths. The application of surgical navigation systems can significantly improve the safety and accuracy of implantation. However, the frequent shift of the views of the surgeon between the surgical site and the computer screen causes troubles, which is expected to be solved by the introduction of mixed-reality technology through the wearing of HoloLens devices by enabling the alignment of the virtual three-dimensional (3D) image with the actual surgical site in the same field of view. METHODS This study utilized mixed reality technology to enhance dental implant surgery navigation. Our first step was reconstructing a virtual 3D model from pre-operative cone-beam CT (CBCT) images. We then obtained the relative position between objects using the navigation device and HoloLens camera. Via the algorithms of virtual-actual registration, the transformation matrixes between the HoloLens devices and the navigation tracker were acquired through the HoloLens-tracker registration, and the transformation matrixes between the virtual model and the patient phantom through the image-phantom registration. In addition, the algorithm of surgical drill calibration assisted in acquiring transformation matrixes between the surgical drill and the patient phantom. These algorithms allow real-time tracking of the surgical drill's location and orientation relative to the patient phantom under the navigation device. With the aid of the HoloLens 2, virtual 3D images and actual patient phantoms can be aligned accurately, providing surgeons with a clear visualization of the implant path. RESULTS Phantom experiments were conducted using 30 patient phantoms, with a total of 102 dental implants inserted. Comparisons between the actual implant paths and the pre-operatively planned implant paths showed that our system achieved a coronal deviation of 1.507 ± 0.155 mm, an apical deviation of 1.542 ± 0.143 mm, and an angular deviation of 3.468 ± 0.339°. The deviation was not significantly different from that of the navigation-guided dental implant placement but better than the freehand dental implant placement. CONCLUSION Our proposed system realizes the integration of the pre-operative planned dental implant paths and the patient phantom, which helps surgeons achieve adequate accuracy in traditional dental implant surgery. Furthermore, this system is expected to be applicable to animal and cadaveric experiments in further studies.
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Affiliation(s)
- Xingqi Fan
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Baoxin Tao
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Puxun Tu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Yihan Shen
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yiqun Wu
- Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China; Institute of Medical Robotics, Shanghai Jiao Tong University, Shanghai, China.
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12
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Martinho FC, Griffin IL, Price JB, Tordik PA. Augmented Reality and 3-Dimensional Dynamic Navigation System Integration for Osteotomy and Root-end Resection. J Endod 2023; 49:1362-1368. [PMID: 37453501 DOI: 10.1016/j.joen.2023.07.007] [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: 06/06/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Augmented reality (AR) superimposes high-definition computer-generated virtual content onto the existing environment, providing users with an enhanced perception of reality. This study investigates the feasibility of integrating an AR head-mounted device into a 3-dimensional dynamic navigation system (3D-DNS) for osteotomy and root-end resection (RER). It compares the accuracy and efficiency of AR + 3D-DNS to 3D-DNS for osteotomy and RER. METHODS Seventy-two tooth roots of 3D-printed surgical jaw models were divided into two groups: AR + 3D-DNS (n = 36) and 3D-DNS (n = 36). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were virtually planned on X-guide software and delivered under 3D-DNS guidance. For the AR + 3D-DNS group, an AR head-mounted device (Microsoft HoloLens 2) was integrated into the 3D-DNS. The 2D- and 3D-deviations were calculated. The osteotomy and RER time and the number of procedural mishaps were recorded. RESULTS Osteotomy and RER were completed in all samples (72/72). AR + 3D-DNS was more accurate than 3D-DNS, showing lower 2D- and 3D-deviation values (P < .05). The AR + 3D-DNS was more efficient in time than 3D-DNS (P < .05). There was no significant difference in the number of mishaps (P > .05). CONCLUSIONS Within the limitations of this in vitro study, the integration of an AR head-mounted device to 3D-DNS is feasible for osteotomy and RER. AR improved the accuracy and time efficiency of 3D-DNS in osteotomy and RER. Head-mounted AR has the potential to be safely and reliably integrated into 3D-DNS for endodontic microsurgery.
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Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| | - Ina L Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
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13
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Remschmidt B, Rieder M, Gsaxner C, Gaessler J, Payer M, Wallner J. Augmented Reality-Guided Apicoectomy Based on Maxillofacial CBCT Scans. Diagnostics (Basel) 2023; 13:3037. [PMID: 37835780 PMCID: PMC10572956 DOI: 10.3390/diagnostics13193037] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 09/13/2023] [Accepted: 09/21/2023] [Indexed: 10/15/2023] Open
Abstract
Implementation of augmented reality (AR) image guidance systems using preoperative cone beam computed tomography (CBCT) scans in apicoectomies promises to help surgeons overcome iatrogenic complications associated with this procedure. This study aims to evaluate the intraoperative feasibility and usability of HoloLens 2, an established AR image guidance device, in the context of apicoectomies. Three experienced surgeons carried out four AR-guided apicoectomies each on human cadaver head specimens. Preparation and operating times of each procedure, as well as the subjective usability of HoloLens for AR image guidance in apicoectomies using the System Usability Scale (SUS), were measured. In total, twelve AR-guided apicoectomies on six human cadaver head specimens were performed (n = 12). The average preparation time amounted to 162 (±34) s. The surgical procedure itself took on average 9 (±2) min. There was no statistically significant difference between the three surgeons. Quantification of the usability of HoloLens revealed a mean SUS score of 80.4 (±6.8), indicating an "excellent" usability level. In conclusion, this study implies the suitability, practicality, and simplicity of AR image guidance systems such as the HoloLens in apicoectomies and advocates their routine implementation.
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Affiliation(s)
- Bernhard Remschmidt
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Marcus Rieder
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria
| | - Jan Gaessler
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Michael Payer
- Division of Oral Surgery and Orthodontics, Department of Dental Medicine and Oral Health, Medical University of Graz, 8010 Graz, Austria
| | - Juergen Wallner
- Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria
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14
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Riad Deglow E, Zubizarreta-Macho Á, González Menéndez H, Lorrio Castro J, Galparsoro Catalán A, Tzironi G, Lobo Galindo AB, Alonso Ezpeleta LÓ, Hernández Montero S. Comparative analysis of two navigation techniques based on augmented reality technology for the orthodontic mini-implants placement. BMC Oral Health 2023; 23:542. [PMID: 37543581 PMCID: PMC10403882 DOI: 10.1186/s12903-023-03261-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/28/2023] [Indexed: 08/07/2023] Open
Abstract
To analyze and compare the accuracy and root contact prevalence, comparing a conventional freehand technique and two navigation techniques based on augmented reality technology for the orthodontic self-drilling mini-implants placement. Methods Two hundred and seven orthodontic self-drilling mini-implants were placed using either a conventional freehand technique (FHT) and two navigation techniques based on augmented reality technology (AR TOOTH and AR SCREWS). Accuracy across different dental sectors was also analyzed. CBCT and intraoral scans were taken both prior to and following orthodontic self-drilling mini-implants placement. The deviation angle and horizontal were then analyzed; these measurements were taken at the coronal entry point and apical endpoint between the planned and performed orthodontic self-drilling mini-implants. In addition, any complications resulting from mini-implant placement, such as spot perforations, were also analyzed across all dental sectors.Results The statistical analysis showed significant differences between study groups with regard to the coronal entry-point (p < 0.001), apical end-point(p < 0.001) and angular deviations (p < 0.001). Furthermore, statistically significant differences were shown between the orthodontic self-drilling mini-implants placement site at the coronal entry-point (p < 0.0001) and apical end-point (p < 0.001). Additionally, eight root perforations were observed in the FHT group, while there were no root perforations in the two navigation techniques based on augmented reality technology.Conclusions The navigation techniques based on augmented reality technology has an effect on the accuracy of orthodontic self-drilling mini-implants placement and results in fewer intraoperative complications, comparing to the conventional free-hand technique. The AR TOOTH augmented reality technique showed more accurate results between planned and placed orthodontic self-drilling mini-implants, comparing to the AR SCREWS and conventional free-hand techniques. The navigation techniques based on augmented reality technology showed fewer intraoperative complications, comparing to the conventional free-hand technique.
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Affiliation(s)
- Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Héctor González Menéndez
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
| | - Juan Lorrio Castro
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
| | - Agustín Galparsoro Catalán
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
| | - Georgia Tzironi
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Ana Belén Lobo Galindo
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | | | - Sofía Hernández Montero
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda Universidad, 1. 28691, Villanueva de La Cañada, Madrid, Spain
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15
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Fujioka-Kobayashi M, Miyasaka N, Miyasaka A, Koyanagi M, Inada R, Miyasaka T, Satomi T. A Custom-Made Surgical Guide for Accurate Enucleation of Nasopalatine Duct Cysts: A Technical Note and Case Report. Case Rep Dent 2023; 2023:9246701. [PMID: 37560508 PMCID: PMC10409577 DOI: 10.1155/2023/9246701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/18/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
Nasopalatine cysts are common nonodontogenic cysts that occur in the maxilla. During the nucleation of large cysts extending to the floor of the nasal cavity, care must be taken to avoid damage to the nasal mucosa. In the present report, an innovative custom-made surgical guide made by a Three-dimensional printer is introduced for accurate enucleation surgery. The patient's cone-beam computerized tomography and dental model scan data were obtained, and a tooth-supported type of surgical guide was designed containing a circular plate structure showing the size of the cystic region, an indicator that showed the position of the bottom of the cyst, and a sliding stopper that was used to accurately indicate the position of the deepest cyst wall. The surgical tool enabled us to indicate the accurate size, location of the cysts, and approach direction. Although effective and accurate navigation systems have become increasingly available, the cost-effective and accurate computer-aided design/computer-aided manufacturing surgical guide system introduced in the present report could support the safe enucleation of large nasopalatine duct cysts.
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Affiliation(s)
- Masako Fujioka-Kobayashi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Naoki Miyasaka
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Ayako Miyasaka
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Masateru Koyanagi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Ryo Inada
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Takahiro Miyasaka
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
| | - Takafumi Satomi
- Department of Oral and Maxillofacial Surgery, School of Life Dentistry at Tokyo, The Nippon Dental University, Tokyo, Japan
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Gsaxner C, Li J, Pepe A, Jin Y, Kleesiek J, Schmalstieg D, Egger J. The HoloLens in medicine: A systematic review and taxonomy. Med Image Anal 2023; 85:102757. [PMID: 36706637 DOI: 10.1016/j.media.2023.102757] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 01/05/2023] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
The HoloLens (Microsoft Corp., Redmond, WA), a head-worn, optically see-through augmented reality (AR) display, is the main player in the recent boost in medical AR research. In this systematic review, we provide a comprehensive overview of the usage of the first-generation HoloLens within the medical domain, from its release in March 2016, until the year of 2021. We identified 217 relevant publications through a systematic search of the PubMed, Scopus, IEEE Xplore and SpringerLink databases. We propose a new taxonomy including use case, technical methodology for registration and tracking, data sources, visualization as well as validation and evaluation, and analyze the retrieved publications accordingly. We find that the bulk of research focuses on supporting physicians during interventions, where the HoloLens is promising for procedures usually performed without image guidance. However, the consensus is that accuracy and reliability are still too low to replace conventional guidance systems. Medical students are the second most common target group, where AR-enhanced medical simulators emerge as a promising technology. While concerns about human-computer interactions, usability and perception are frequently mentioned, hardly any concepts to overcome these issues have been proposed. Instead, registration and tracking lie at the core of most reviewed publications, nevertheless only few of them propose innovative concepts in this direction. Finally, we find that the validation of HoloLens applications suffers from a lack of standardized and rigorous evaluation protocols. We hope that this review can advance medical AR research by identifying gaps in the current literature, to pave the way for novel, innovative directions and translation into the medical routine.
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Affiliation(s)
- Christina Gsaxner
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria.
| | - Jianning Li
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Antonio Pepe
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Yuan Jin
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Research Center for Connected Healthcare Big Data, Zhejiang Lab, Hangzhou, 311121 Zhejiang, China
| | - Jens Kleesiek
- Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
| | - Dieter Schmalstieg
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; BioTechMed, 8010 Graz, Austria
| | - Jan Egger
- Institute of Computer Graphics and Vision, Graz University of Technology, 8010 Graz, Austria; Institute of AI in Medicine, University Medicine Essen, 45131 Essen, Germany; BioTechMed, 8010 Graz, Austria; Cancer Research Center Cologne Essen, University Medicine Essen, 45147 Essen, Germany
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17
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Mangano FG, Admakin O, Lerner H, Mangano C. Artificial Intelligence and Augmented Reality for Guided Implant Surgery Planning: a Proof of Concept. J Dent 2023; 133:104485. [PMID: 36965859 DOI: 10.1016/j.jdent.2023.104485] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/08/2023] [Accepted: 03/13/2023] [Indexed: 03/27/2023] Open
Abstract
PURPOSE To present a novel protocol for authentic three-dimensional (3D) planning of dental implants, using artificial intelligence (AI) and augmented reality (AR). METHODS The novel protocol consists of (1) 3D data acquisition, with an intraoral scanner (IOS) and cone-beam computed tomography (CBCT); (2) application of AI for CBCT segmentation to obtain standard tessellation language (STL) models and automatic alignment with IOS models; (3) loading of selected STL models within the AR system and surgical planning with holograms; (4) surgical guide design with open-source computer-assisted-design (CAD) software; and (5) surgery on the patient. RESULTS This novel protocol is effective and time-efficient when used for planning simple cases of static guided implant surgery in the partially edentulous patient. The clinician can plan the implants in an authentic 3D environment, without using any radiological guided surgery software. The precision of implant placement looks clinically acceptable, with minor deviations. CONCLUSIONS AI and AR technologies can be successfully used for planning guided implant surgery for authentic 3D planning that may replace conventional guided surgery software. However, further clinical studies are needed to validate this protocol. STATEMENT OF CLINICAL RELEVANCE The combined use of AI and AR may change the perspectives of modern guided implant surgery for authentic 3D planning that may replace conventional guided surgery software.
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Affiliation(s)
- Francesco Guido Mangano
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russian Federation; Honorary Professor in Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, China.
| | - Oleg Admakin
- Department of Pediatric, Preventive Dentistry and Orthodontics, Sechenov First State Medical University, Moscow, Russian Federation.
| | - Henriette Lerner
- Academic Teaching and Research Institution of Johann Wolfgang Goethe University, Frankfurt, Germany.
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González Rueda JR, Galparsoro Catalán A, de Paz Hermoso VM, Riad Deglow E, Zubizarreta-Macho Á, Pato Mourelo J, Montero Martín J, Hernández Montero S. Accuracy of computer-aided static and dynamic navigation systems in the placement of zygomatic dental implants. BMC Oral Health 2023; 23:150. [PMID: 36918837 PMCID: PMC10015906 DOI: 10.1186/s12903-023-02856-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/04/2023] [Indexed: 03/16/2023] Open
Abstract
BACKGROUND Zygomatic implants are widely used in the rehabilitation of severely atrophic maxillae, but implant placement is not without risks, and it can potentially cause damage to related anatomical structures. The aim of this study was to perform a comparative analysis of the accuracy of static navigation systems in placing zygomatic dental implants in comparison to dynamic navigation systems. METHODS Sixty zygomatic dental implants were randomly allocated to one of three study groups, categorized by which implant placement strategy was used: A: computer-aided static navigation system (n = 20) (GI); B: computer-aided dynamic navigation system (n = 20) (NI); or C: free-hand technique (n = 20) (FHI). For the computer-aided study groups, a preoperative cone-beam computed tomography (CBCT) scan of the existing situation was performed in order to plan the approach to be used during surgery. Four zygomatic dental implants were inserted in each of fifteen polyurethane stereolithographic models (n = 15), with a postoperative CBCT scan taken after the intervention. The pre- and postoperative CBCT scans were then uploaded to a software program used in dental implantology to analyze the angular deviations, apical end point, and coronal entry point. Student's t-test was used to analyze the results. RESULTS The results found statistically significant differences in apical end-point deviations between the FHI and NI (p = 0.0053) and FHI and GI (p = 0.0004) groups. There were also statistically significant differences between the angular deviations of the FHI and GI groups (p = 0.0043). CONCLUSIONS The manual free-hand technique may enable more accurate placement of zygomatic dental implants than computer-assisted surgical techniques due to the different learning curves required for each zygomatic dental implant placement techniques.
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Affiliation(s)
- Juan Ramón González Rueda
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Agustín Galparsoro Catalán
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | | | - Elena Riad Deglow
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
| | - Álvaro Zubizarreta-Macho
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
- grid.11762.330000 0001 2180 1817Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Jesús Pato Mourelo
- grid.5924.a0000000419370271Department of Surgery, Faculty of Dentistry, University of Navarra, 31009 Pamplona, Navarra Spain
| | - Javier Montero Martín
- grid.11762.330000 0001 2180 1817Department of Surgery, Faculty of Medicine, University of Salamanca, 37008 Salamanca, Spain
| | - Sofía Hernández Montero
- grid.464699.00000 0001 2323 8386Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, Avda. Universidad, 1, Villanueva de la Cañada, 28691 Madrid, Spain
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Novel method for augmented reality guided endodontics: an in vitro study. J Dent 2023; 132:104476. [PMID: 36905949 DOI: 10.1016/j.jdent.2023.104476] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 02/02/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023] Open
Abstract
OBJECTIVE The aim of this study is to evaluate the accuracy in endodontics of a novel augmented reality (AR) method for guided access cavity preparation in 3D-printed jaws. METHODS Two operators with different levels of experience in endodontics performed pre-planned virtually guided access cavities through a novel markerless AR system developed by a team among the authors on three sets of 3D-printed jaw models using a 3D printer (Objet Connex 350, Stratasys) mounted on a phantom. After the treatment, a post-operative high-resolution CBCT scan (NewTom VGI Evo, Cefla) was taken for each model and registered to the pre-operative model. All the access cavities were then digitally reconstructed by filling the cavity area using 3D medical software (3-Matic 15.0, Materialise). For the anterior teeth and the premolars, the deviation at the coronal and apical entry points as well as the angular deviation of the access cavity were compared to the virtual plan. For the molars, the deviation at the coronal entry point was compared to the virtual plan. Additionally, the surface area of all access cavities at the entry point was measured and compared to the virtual plan. Descriptive statistics for each parameter were performed. A 95% confidence interval was calculated. RESULTS A total of 90 access cavities were drilled up to a depth of 4 mm inside the tooth. The mean deviation in the frontal teeth and in the premolars at the entry point was 0.51 mm and 0.77 mm at the apical point, with a mean angular deviation of 8.5° and a mean surface overlap of 57%. The mean deviation for the molars at the entry point was 0.63 mm, with a mean surface overlap of 82%. CONCLUSION The use of AR as a digital guide for endodontic access cavity drilling on different teeth showed promising results and might have potential for clinical use. However, further development and research might be needed before in vivo validation to overcome the limitations of the study.
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Liu L, Wang X, Guan M, Fan Y, Yang Z, Li D, Bai Y, Li H. A mixed reality-based navigation method for dental implant navigation method: A pilot study. Comput Biol Med 2023; 154:106568. [PMID: 36739818 DOI: 10.1016/j.compbiomed.2023.106568] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/28/2022] [Accepted: 01/22/2023] [Indexed: 01/25/2023]
Abstract
This in vitro study aimed to put forward the development and investigation of a novel Mixed Reality (MR)-based dental implant navigation method and evaluate implant accuracy. Data were collected using 3D-cone beam computed tomography. The MR-based navigation system included a Hololens headset, an NDI (Northern Digital Inc.) Polaris optical tracking system, and a computer. A software system was developed. Resin models of dentition defects were created for a randomized comparison study with the MR-based navigation implantation system (MR group, n = 25) and the conventional free-hand approach (FH group, n = 25). Implant surgery on the models was completed by an oral surgeon. The precision and feasibility of the MR-based navigation method in dental implant surgery were assessed and evaluated by calculating the entry deviation, middle deviation, apex deviation, and angular deviation values of the implant. The system, including both the hardware and software, for the MR-based dental implant navigation method were successfully developed and a workflow of the method was established. Three-Dimensional (3D) reconstruction and visualization of the surgical instruments, dentition, and jawbone were achieved. Real-time tracking of implant tools and jaw model, holographic display via the MR headset, surgical guidance, and visualization of the intraoperative implant trajectory deviation from the planned trajectory were captured by our system. The MR-based navigation system was with better precise than the free-hand approach for entry deviation (MR: 0.6914 ± 0.2507 mm, FH: 1.571 ± 0.5004 mm, P = 0.000), middle deviation (MR: 0.7156 ± 0.2127 mm, FH: 1.170 ± 0.3448 mm, P = 0.000), apex deviation (MR: 0.7869 ± 0.2298 mm, FH: 0.9190 ± 0.3319 mm, P = 0.1082), and angular deviation (MR: 1.849 ± 0.6120°, FH: 4.933 ± 1.650°, P = 0.000).
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Affiliation(s)
- Lin Liu
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Xiaoyu Wang
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China; Department of Stomatology, PLA Strategic Support Force Special Medical Center, Beijing, 100101, China
| | - Miaosheng Guan
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China; PLA Rocket Force Characteristic Medical Center, Beijing, 100088, China
| | - Yiping Fan
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Zhongliang Yang
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China
| | - Deyu Li
- Beijing Visual 3D Medical Science and Technology Development Co., LTD., Beijing, 100000, China.
| | - Yuming Bai
- Beijing Visual 3D Medical Science and Technology Development Co., LTD., Beijing, 100000, China
| | - Hongbo Li
- Department of Stomatology, The First Medical Center of PLA General Hospital, Beijing, 100853, China.
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Benmahdjoub M, Thabit A, van Veelen MLC, Niessen WJ, Wolvius EB, Walsum TV. Evaluation of AR visualization approaches for catheter insertion into the ventricle cavity. IEEE TRANSACTIONS ON VISUALIZATION AND COMPUTER GRAPHICS 2023; PP:2434-2445. [PMID: 37027733 DOI: 10.1109/tvcg.2023.3247042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Augmented reality (AR) has shown potential in computer-aided surgery. It allows for the visualization of hidden anatomical structures as well as assists in navigating and locating surgical instruments at the surgical site. Various modalities (devices and/or visualizations) have been used in the literature, but few studies investigated the adequacy/superiority of one modality over the other. For instance, the use of optical see-through (OST) HMDs has not always been scientifically justified. Our goal is to compare various visualization modalities for catheter insertion in external ventricular drain and ventricular shunt procedures. We investigate two AR approaches: (1) 2D approaches consisting of a smartphone and a 2D window visualized through an OST (Microsoft HoloLens 2), and (2) 3D approaches consisting of a fully aligned patient model and a model that is adjacent to the patient and is rotationally aligned using an OST. 32 participants joined this study. For each visualization approach, participants were asked to perform five insertions after which they filled NASA-TLX and SUS forms. Moreover, the position and orientation of the needle with respect to the planning during the insertion task were collected. The results show that participants achieved a better insertion performance significantly under 3D visualizations, and the NASA-TLX and SUS forms reflected the preference of participants for these approaches compared to 2D approaches.
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22
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Leung T, Dam VV, Lee DH. Accuracy of Augmented Reality-Assisted Navigation in Dental Implant Surgery: Systematic Review and Meta-analysis. J Med Internet Res 2023; 25:e42040. [PMID: 36598798 PMCID: PMC9856431 DOI: 10.2196/42040] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/09/2022] [Accepted: 11/25/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The novel concept of immersive 3D augmented reality (AR) surgical navigation has recently been introduced in the medical field. This method allows surgeons to directly focus on the surgical objective without having to look at a separate monitor. In the dental field, the recently developed AR-assisted dental implant navigation system (AR navigation), which uses innovative image technology to directly visualize and track a presurgical plan over an actual surgical site, has attracted great interest. OBJECTIVE This study is the first systematic review and meta-analysis study that aimed to assess the accuracy of dental implants placed by AR navigation and compare it with that of the widely used implant placement methods, including the freehand method (FH), template-based static guidance (TG), and conventional navigation (CN). METHODS Individual search strategies were used in PubMed (MEDLINE), Scopus, ScienceDirect, Cochrane Library, and Google Scholar to search for articles published until March 21, 2022. This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database. Peer-reviewed journal articles evaluating the positional deviations of dental implants placed using AR-assisted implant navigation systems were included. Cohen d statistical power analysis was used to investigate the effect size estimate and CIs of standardized mean differences (SMDs) between data sets. RESULTS Among the 425 articles retrieved, 15 articles were considered eligible for narrative review, 8 articles were considered for single-arm meta-analysis, and 4 were included in a 2-arm meta-analysis. The mean lateral, global, depth, and angular deviations of the dental implant placed using AR navigation were 0.90 (95% CI 0.78-1.02) mm, 1.18 (95% CI 0.95-1.41) mm, 0.78 (95% CI 0.48-1.08) mm, and 3.96° (95% CI 3.45°-4.48°), respectively. The accuracy of AR navigation was significantly higher than that of the FH method (SMD=-1.01; 95% CI -1.47 to -0.55; P<.001) and CN method (SMD=-0.46; 95% CI -0.64 to -0.29; P<.001). However, the accuracies of the AR navigation and TG methods were similar (SMD=0.06; 95% CI -0.62 to 0.74; P=.73). CONCLUSIONS The positional deviations of AR-navigated implant placements were within the safety zone, suggesting clinically acceptable accuracy of the AR navigation method. Moreover, the accuracy of AR implant navigation was comparable with that of the highly recommended dental implant-guided surgery method, TG, and superior to that of the conventional FH and CN methods. This review highlights the possibility of using AR navigation as an effective and accurate immersive surgical guide for dental implant placement.
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Affiliation(s)
| | - Van Viet Dam
- Department of Implantology, Hanoi National Hospital of Odonto-stomatology, Hanoi, Vietnam.,VNU School of Medicine and Pharmacy, Vietnam National University, Hanoi, Vietnam
| | - Du-Hyeong Lee
- Institute for Translational Research in Dentistry, Kyungpook National University, Daegu, Republic of Korea.,Department of Prosthodontics, School of Dentistry, Kyungpook National University, Daegu, Republic of Korea
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Grad P, Przeklasa-Bierowiec AM, Malinowski KP, Witowski J, Proniewska K, Tatoń G. Application of HoloLens-based augmented reality and three-dimensional printed anatomical tooth reference models in dental education. ANATOMICAL SCIENCES EDUCATION 2022. [PMID: 36524288 DOI: 10.1002/ase.2241] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 06/17/2023]
Abstract
Tooth anatomy is fundamental knowledge used in everyday dental practice to reconstruct the occlusal surface during cavity fillings. The main objective of this project was to evaluate the suitability of two types of anatomical tooth reference models used to support reconstruction of the occlusal anatomy of the teeth: (1) a three-dimensional (3D)-printed model and (2) a model displayed in augmented reality (AR) using Microsoft HoloLens. The secondary objective was to evaluate three aspects impacting the outcome: clinical experience, comfort of work, and other variables. The tertiary objective was to evaluate the usefulness of AR in dental education. Anatomical models of crowns of three different molars were made using cone beam computed tomography image segmentation, printed with a stereolithographic 3D-printer, and then displayed in the HoloLens. Each participant reconstructed the occlusal anatomy of three teeth. One without any reference materials and two with an anatomical reference model, either 3D-printed or holographic. The reconstruction work was followed by the completion of an evaluation questionnaire. The maximum Hausdorff distances (Hmax) between the superimposed images of the specimens after the procedures and the anatomical models were then calculated. The results showed that the most accurate but slowest reconstruction was achieved with the use of 3D-printed reference models and that the results were not affected by other aspects considered. For this method, the Hmax was observed to be 630 μm (p = 0.004). It was concluded that while AR models can be helpful in dental anatomy education, they are not suitable replacements for physical models.
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Affiliation(s)
- Piotr Grad
- Department of Integrated Dentistry, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Anna M Przeklasa-Bierowiec
- Department of Integrated Dentistry, Institute of Dentistry, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Krzysztof P Malinowski
- Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Jan Witowski
- Department of Radiology, New York University Grossman School of Medicine, New York, New York, USA
| | - Klaudia Proniewska
- Department of Bioinformatics and Telemedicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Grzegorz Tatoń
- Department of Biophysics, Chair of Physiology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
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Faus-Matoses V, Faus-Llácer V, Moradian T, Riad Deglow E, Ruiz-Sánchez C, Hamoud-Kharrat N, Zubizarreta-Macho Á, Faus-Matoses I. Accuracy of Endodontic Access Cavities Performed Using an Augmented Reality Appliance: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11167. [PMID: 36141439 PMCID: PMC9517686 DOI: 10.3390/ijerph191811167] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/29/2022] [Accepted: 09/03/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The purpose of this study was to compare and contrast the accuracy of endodontic access cavities created using an augmented reality appliance to those performed using the conventional technique. MATERIALS AND METHODS 60 single-rooted anterior teeth were chosen for study and randomly divided between two study groups: Group A-endodontic access cavities created using an augmented reality appliance as a guide (n = 30) (AR); and Group B-endodontic access cavities performed with the manual (freehand) technique (n = 30) (MN). A 3D implant planning software was used to plan the endodontic access cavities for the AR group, with a cone-beam computed tomography (CBCT) and 3D intraoral surface scan taken preoperatively and subsequently transferred to the augmented reality device. A second CBCT scan was taken after performing the endodontic access cavities to compare the planned and performed endodontic access for accuracy. Therapeutic planning software and Student's t-test were used to analyze the cavities at the apical, coronal, and angular levels. The repeatability and reproducibility of the digital measurement technique were analyzed using Gage R&R statistical analysis. RESULTS The paired t-test found statistically significant differences between the study groups at the coronal (p = 0.0029) and apical (p = 0.0063) levels; no statistically significant differences were found between the AR and MN groups at the angular (p = 0.6596) level. CONCLUSIONS Augmented reality devices enable the safer and more accurate performance of endodontic access cavities when compared with the conventional freehand technique.
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Affiliation(s)
- Vicente Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Vicente Faus-Llácer
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Tanaz Moradian
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Elena Riad Deglow
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
| | - Celia Ruiz-Sánchez
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Nirmine Hamoud-Kharrat
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
| | - Álvaro Zubizarreta-Macho
- Department of Implant Surgery, Faculty of Health Sciences, Alfonso X El Sabio University, 28691 Madrid, Spain
- Department of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, Spain
| | - Ignacio Faus-Matoses
- Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, 46010 Valencia, Spain
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Böse MWH, Beuer F, Schwitalla A, Bruhnke M, Herklotz I. Dynamic navigation for dental implant placement in single-tooth gaps: A preclinical pilot investigation. J Dent 2022; 125:104265. [PMID: 35995082 DOI: 10.1016/j.jdent.2022.104265] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 07/26/2022] [Accepted: 08/18/2022] [Indexed: 10/15/2022] Open
Abstract
OBJECTIVES To compare the planned (PIP) and transferred implant position (TIP) after dental implant placement in single-tooth gaps utilizing dynamic computer-assisted implant surgery (dCAIS). METHODS Five pairs of artificial jaws (n = 5) with four single tooth gaps in FDI (Fédération Dentaire Internationale) regions 16, 25, 36 and 44 were manufactured via injection molding technique. Cone beam computed tomographies (CBCTs) were made and digital implant planning of twenty implants (n = 20) was performed with a dynamic navigation system (DNS, Navident, ClaroNav, Toronto, Canada). After guided drilling and manual implant placement, post-operative CBCTs were made. Global deviations at entry point (two-dimensional, 2D), apex (three-dimensional, 3D), apex (vertical, V) and angulation (in degrees, °) were calculated by DNS software. For statistical analysis, level of significance was set to p < 0.05. RESULTS Mean deviation at the implants entry point (2D) was 0.78 ± 0.45 mm (range: 0.10-1.63 mm). For the implants apex (3D) and the implants apex (V) deviations were 1.08 ± 0.50 mm (range: 0.33-2.10 mm) and 0.32 ± 0.22 mm (range: 0.02-0.90 mm), respectively. The median angular deviation (°) was 2.81 ± 2.29° (range: 0.56-9.58°). Statistically significant differences (p < 0.05) were found regarding apex (3D), apex (V), and angulation (°) comparing I.-IV. quadrants. CONCLUSIONS Using the investigated dCAIS seems to provide satisfactory results regarding TIP in single-tooth gaps in vitro. Due to documented deviations, a safety distance of more than 2 mm should be respected while implant planning in DNS software. CLINICAL SIGNIFICANCE The investigated DNS seems to be reliant in transferring PIP with acceptable deviations in vitro.
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Affiliation(s)
- Mats Wernfried Heinrich Böse
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany.
| | - Florian Beuer
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Andreas Schwitalla
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Maria Bruhnke
- Department of Prosthodontics, Geriatric Dentistry and Craniomandibular Disorders, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Aßmannshauser Str. 4-6, Berlin 14197, Germany
| | - Insa Herklotz
- Dental Office Amalienpark - Dr. Herklotz & Dr. Thiele, Amalienpark 1, Berlin 13187, Germany
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Abstract
Augmented reality (AR) was first described in the literature in the 1990s. It has been shown as a futuristic concept in television, film and media, and now in the twenty-first century has become a reality. AR is defined as an interactive experience of a real-world environment where the object that resides in the real world is enhanced by computer-generated perceptual information.Microsoft HoloLens is a mixed reality device which has the capability to provide a real-time, three-dimensional platform using multiple sensors and holographic processing to display information and even simulate a virtual world. With rapidly evolving technology and virtual learning on the increase, the HoloLens technology can be used as a vital tool for dental education and surgical planning. However, within dentistry at present, there is limited research regarding its benefits and potential.The authors would like to demonstrate the use of HoloLens in three common oral surgery procedures and how it can be used to distinguish anatomy and benefit surgical planning, aid in patient communication and play a role in dental education.
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Dynamic Navigation System for Immediate Implant Placement in the Maxillary Aesthetic Region. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
(1) Background: The achievement of an optimal implant position is still a critical consideration in implantology, especially in the aesthetic area. Dynamic navigation is a computer-aided procedure that allows the surgeon to follow on a screen the three-dimensional position of instruments in real time during implant site preparation. The aim of this proof-of-concept study was to assess the clinical and radiographical performance and accuracy of the surgical workflow during maxillary immediate implant placement assisted by DTX studio Implant software planning and X-Guide Navigation. (2) Methods: Twelve consecutive patients requiring at least one implant in the maxillary aesthetic region were treated. Clinical outcome measures were biological complications and implant or prosthetic success rate. The accuracy was measured by calculating the deviation between the real implant position obtained from the postoperative cone beam computed tomography (CBCT) scan and the planned implant position. (3) Results: The average deviation at the implant shoulder was 0.77 ± 0.25 mm and at the apical point was 1.2 ± 0.61 mm. The depth error was 0.5 ± 0.21 mm. The axis deviation was 2.5 ± 0.41 degrees. No biological complications or implant and prosthetic failures occurred after mean 6-month follow-up. (4) Conclusions: Within the limitations of this study, it seems that the dynamic navigation system for implant placement in the maxillary aesthetic region is accurate for prosthetically driven implant placement.
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Accuracy of dental implant placement using augmented reality-based navigation, static computer assisted implant surgery, and the free-hand method: An in vitro study In vitro evaluation of accuracy of dental implant placement guided by three distinct navigational methods. J Dent 2022; 119:104070. [DOI: 10.1016/j.jdent.2022.104070] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Revised: 02/03/2022] [Accepted: 02/16/2022] [Indexed: 12/17/2022] Open
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Ochandiano S, García-Mato D, Gonzalez-Alvarez A, Moreta-Martinez R, Tousidonis M, Navarro-Cuellar C, Navarro-Cuellar I, Salmerón JI, Pascau J. Computer-Assisted Dental Implant Placement Following Free Flap Reconstruction: Virtual Planning, CAD/CAM Templates, Dynamic Navigation and Augmented Reality. Front Oncol 2022; 11:754943. [PMID: 35155183 PMCID: PMC8833256 DOI: 10.3389/fonc.2021.754943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Accepted: 12/24/2021] [Indexed: 12/16/2022] Open
Abstract
Image-guided surgery, prosthetic-based virtual planning, 3D printing, and CAD/CAM technology are changing head and neck ablative and reconstructive surgical oncology. Due to quality-of-life improvement, dental implant rehabilitation could be considered in every patient treated with curative intent. Accurate implant placement is mandatory for prosthesis long-term stability and success in oncologic patients. We present a prospective study, with a novel workflow, comprising 11 patients reconstructed with free flaps and 56 osseointegrated implants placed in bone flaps or remnant jaws (iliac crest, fibula, radial forearm, anterolateral thigh). Starting from CT data and jaw plaster model scanning, virtual dental prosthesis was designed. Then prosthetically driven dental implacement was also virtually planned and transferred to the patient by means of intraoperative infrared optical navigation (first four patients), and a combination of conventional static teeth supported 3D-printed acrylic guide stent, intraoperative dynamic navigation, and augmented reality for final intraoperative verification (last 7 patients). Coronal, apical, and angular deviation between virtual surgical planning and final guided intraoperative position was measured on each implant. There is a clear learning curve for surgeons when applying guided methods. Initial only-navigated cases achieved low accuracy but were comparable to non-guided freehand positioning due to jig registration instability. Subsequent dynamic navigation cases combining highly stable acrylic static guides as reference and registration markers result in the highest accuracy with a 1–1.5-mm deviation at the insertion point. Smartphone-based augmented reality visualization is a valuable tool for intraoperative visualization and final verification, although it is still a difficult technique for guiding surgery. A fixed screw-retained ideal dental prosthesis was achieved in every case as virtually planned. Implant placement, the final step in free flap oncological reconstruction, could be accurately planned and placed with image-guided surgery, 3D printing, and CAD/CAM technology. The learning curve could be overcome with preclinical laboratory training, but virtually designed and 3D-printed tracer registration stability is crucial for accurate and predictable results. Applying these concepts to our difficult oncologic patient subgroup with deep anatomic alterations ended in comparable results as those reported in non-oncologic patients.
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Affiliation(s)
- Santiago Ochandiano
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- *Correspondence: Santiago Ochandiano,
| | - David García-Mato
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Alba Gonzalez-Alvarez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Rafael Moreta-Martinez
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
| | - Manuel Tousidonis
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carlos Navarro-Cuellar
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ignacio Navarro-Cuellar
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - José Ignacio Salmerón
- Servicio de Cirugía Oral y Maxilofacial, Hospital General Universitario Gregorio Marañón, Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Javier Pascau
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Madrid, Spain
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Kortekamp SS, Ickerott I, Teuteberg F. Technikgestützte zahnmedizinische Hausbesuche durch nicht-ärztliches Fachpersonal zur Minderung des Ansteckungsrisikos. HMD PRAXIS DER WIRTSCHAFTSINFORMATIK 2021. [PMCID: PMC8153096 DOI: 10.1365/s40702-021-00733-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ZusammenfassungZiel des Beitrags ist die Identifikation von Problemen, Meta-Anforderungen und Designprinzipien für den Einsatz von Mixed und Virtual Reality Brillen zur Unterstützung nicht-ärztlichen Fachpersonals bei zahnmedizinischen Hausbesuchen. Im Rahmen von zwei Gruppendiskussionen und einem Experteninterview wurden zunächst mögliche Einsatzszenarien identifiziert. Anschließend wurde eine systematische Literaturrecherche in den Datenbanken CINAHL, Business Source Premier und MEDLINE durchgeführt. In der gefundenen Literatur konnten 14 Probleme bei der Anwendung von Mixed und Virtual Reality Brillen identifiziert werden. Darauf basierend wurden 14 Meta-Anforderungen abgeleitet und in fünf Designprinzipien zusammengefasst. Abschließend wurden die Ergebnisse mit den Spezifikationen der Microsoft HoloLens 2 abgeglichen, um eine Eignung für die Unterstützung der geplanten Hausbesuche festzustellen. Zudem wurde ein Umsetzungskonzept skizziert. Die Ergebnisse dienen als wichtige Empfehlungen für die praxisnahe Umsetzung zukünftiger Konzepte bezüglich der Anwendung von Mixed und Virtual Reality Brillen im (zahn-)medizinischen Kontext. Die Literaturrecherche zeigt eine Forschungslücke im Bereich zahnmedizinischer Hausbesuche auf. Die Ergebnisse dieses Beitrags schaffen daher eine solide Basis für die zukünftige Forschung.
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Virtual Reality (VR) Simulation and Augmented Reality (AR) Navigation in Orthognathic Surgery: A Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11125673] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
VR and AR technology have gradually developed to the extent that they could help operators in the surgical field. In this study, we present a case of VR simulation for preoperative planning and AR navigation applied to orthognathic surgery. The average difference between the preplanned data and the post-operative results was 3.00 mm, on average, and the standard deviation was 1.44 mm. VR simulation could provide great advantages for 3D medical simulations, with accurate manipulation and immersiveness. AR navigation has great potential in medical application; its advantages include displaying real time augmented 3D models of patients. Moreover, it is easily applied in the surgical field, without complicated 3D simulations or 3D-printed surgical guides.
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Mladenovic R, Djordjevic F. Effectiveness of virtual reality as a distraction on anxiety and pain during impacted mandibular third molar surgery under local Anesthesia. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 122:e15-e20. [PMID: 33771743 DOI: 10.1016/j.jormas.2021.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVE The aim of this study was to assess the effectiveness of Virtual Reality (VR) in reducing anxiety and pain during impacted mandibular third molar extraction under local anesthesia. METHODS The study was designed as a prospective clinical study covering 74 respondents over 20 years of age. Surgical extraction of both impacted mandibular third molars was performed in two phases, two weeks apart. In the first phase, surgical extraction of the tooth was performed following the standard procedure (Non VR), and in the second phase (VR), we used VR goggles as an auxiliary tool for distraction during the procedure. Face scale was used to assess the level of pain. Heart rate values were recorded by means of wristbands. After both procedures, the patients filled out a modified post-clinical satisfaction questionnaire. RESULTS During the procedure with VR goggles, the respondents had significantly lower pain values during the application of anesthesia, as well as during the surgical extraction of the third molar. There was no statistically significant difference in the level of pain during both surgical procedures with regard to the gender and age. Heart rate values in both phases of the study were not significantly different before the application of anesthesia. When VR goggles were used, the respondents had significantly lower heart rate values before the procedure, as well as during the procedure. Analysis of answers to the post-clinical questionnaire measuring satisfaction with VR technology shows that over 90% of respondents did not experience any VR-related discomfort during the surgery. CONCLUSIONS The VR distraction concept applied during impacted third molar surgery under local anesthesia can help reduce the patients' anxiety and acute pain levels.
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Affiliation(s)
- Rasa Mladenovic
- Faculty of Medicine, Department of Dentistry, University in Pristina, Kosovska Mitrovica, Serbia; Faculty of Medical Sciences, University of Kragujevac, Serbia.
| | - Filip Djordjevic
- Faculty of Medicine, Department of Dentistry, University in Pristina, Kosovska Mitrovica, Serbia
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Effect of Computer-Aided Navigation Techniques on the Accuracy of Endodontic Access Cavities: A Systematic Review and Meta-Analysis. BIOLOGY 2021; 10:biology10030212. [PMID: 33802134 PMCID: PMC7999608 DOI: 10.3390/biology10030212] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 02/25/2021] [Accepted: 03/06/2021] [Indexed: 02/07/2023]
Abstract
The present systematic review and meta-analysis aims to determine the effect of computer-aided navigation techniques on the accuracy of endodontic access cavities. MATERIALS AND METHODS A systematic literature review and meta-analysis of clinical studies, based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations, was performed that evaluated the root canal location rate of computer-aided navigation techniques applied to endodontic access cavities. Four different databases were used to consult the literature: PubMed-Medline, Scopus, Cochrane, and Web of Science. After discarding duplicate articles and applying inclusion criteria, 14 articles were selected for qualitative analysis and 13 for quantitative analysis. RESULTS the root canal location success rate started at 98.1% (CI: 95.7-100%) of the cases performed through a computer-aided navigation technique. The prediction interval ranged from 93.3% to 100%. The meta-analysis did not detect heterogeneity between the combined studies (Q-test = 17.3; p = 0.185; I2 = 25%). No statistically significant differences were found between computer-aided static navigation techniques (success rate: 98.5%) and computer-aided dynamic navigation techniques (success rate: 94.5%) (Q test = 0.57; p = 0.451), nor between in vitro studies (success rate: 96.2%) and in vivo studies (success rate: 100%) (Q test = 2.53; p-value = 0.112). An odds success ratio of 13.1 (CI: 95%; 3.48, 49.1) encourages the use of computer-aided navigation techniques over conventional endodontic access cavity procedures. CONCLUSIONS the endodontic access cavities created using static and dynamic computer-aided navigation techniques are highly accurate in locating the root canal system.
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Lotz M, Schumacher C, Stadlinger B, Ikenberg K, Rücker M, Valdec S. Accuracy of guided biopsy of the jawbone in a clinical setting: A retrospective analysis. J Craniomaxillofac Surg 2021; 49:556-561. [PMID: 33726950 DOI: 10.1016/j.jcms.2021.02.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 01/18/2021] [Accepted: 02/20/2021] [Indexed: 11/28/2022] Open
Abstract
The aim of this study was to investigate the accuracy of a previously described technique for guided biopsy of osseous pathologies of the jawbone in a clinical setting. The data sets of patients who had undergone guided biopsy procedures were retrospectively examined for accuracy. Digital planning of the biopsies and manufacturing of the tooth-supported drilling template were performed with superimposed cone beam computed tomography and intraoral scans using implant planning software. After a trephine biopsy was taken using the template, the postoperative low-dose cone beam computed tomography was analyzed for accuracy using the planning software with the corresponding (digitally-planned) biopsy cylinder. The mean angular deviation was 4.35 ± 2.5°. The mean depth deviation was -1.40 ± 1.41 mm. Guided biopsy seems to be an alternative to a conventional approach for minimally invasive and highly accurate jawbone biopsy.
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Affiliation(s)
- Martin Lotz
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland.
| | - Caterina Schumacher
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Bernd Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Kristian Ikenberg
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
| | - Martin Rücker
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
| | - Silvio Valdec
- Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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Jorba-García A, González-Barnadas A, Camps-Font O, Figueiredo R, Valmaseda-Castellón E. Accuracy assessment of dynamic computer-aided implant placement: a systematic review and meta-analysis. Clin Oral Investig 2021; 25:2479-2494. [PMID: 33635397 DOI: 10.1007/s00784-021-03833-8] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 02/05/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To assess the accuracy of dynamic computer-aided implant surgery (dCAIS) systems when used to place dental implants and to compare its accuracy with static computer-aided implant surgery (sCAIS) systems and freehand implant placement. MATERIALS AND METHODS An electronic search was made to identify all relevant studies reporting on the accuracy of dCAIS systems for dental implant placement. The following PICO question was developed: "In patients or artificial models, is dental implant placement accuracy higher when dCAIS systems are used in comparison with sCAIS systems or with freehand placement? The main outcome variable was angular deviation between the central axes of the planned and final position of the implant. The data were extracted in descriptive tables, and a meta-analysis of single means was performed in order to estimate the deviations for each variable using a random-effects model. RESULTS Out of 904 potential articles, the 24 selected assessed 9 different dynamic navigation systems. The mean angular and entry 3D global deviations for clinical studies were 3.68° (95% CI: 3.61 to 3.74; I2 = 99.4%) and 1.03 mm (95% CI: 1.01 to 1.04; I2 = 82.4%), respectively. Lower deviation values were reported in in vitro studies (mean angular deviation of 2.01° (95% CI: 1.95 to 2.07; I2 = 99.1%) and mean entry 3D global deviation of 0.46 mm (95% CI: 0.44 to 0.48 ; I2 = 98.5%). No significant differences were found between the different dCAIS systems. These systems were significantly more accurate than sCAIS systems (mean difference (MD): -0.86°; 95% CI: -1.35 to -0.36) and freehand implant placement (MD: -4.33°; 95% CI: -5.40 to -3.25). CONCLUSION dCAIS systems allow highly accurate implant placement with a mean angular of less than 4°. However, a 2-mm safety margin should be applied, since deviations of more than 1 mm were observed. dCAIS systems increase the implant placement accuracy when compared with freehand implant placement and also seem to slightly decrease the angular deviation in comparison with sCAIS systems. CLINICAL RELEVANCE The use of dCAIS could reduce the rate of complications since it allows a highly accurate implant placement.
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Affiliation(s)
- Adrià Jorba-García
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Albert González-Barnadas
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Octavi Camps-Font
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
| | - Rui Figueiredo
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain. .,IDIBELL Institute, Barcelona, Spain. .,Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern, 2a Planta, Despatx 2.9, C/Feixa Llarga s/n, E-08907 L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Eduard Valmaseda-Castellón
- Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.,IDIBELL Institute, Barcelona, Spain
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Alauddin MS, Baharuddin AS, Mohd Ghazali MI. The Modern and Digital Transformation of Oral Health Care: A Mini Review. Healthcare (Basel) 2021; 9:healthcare9020118. [PMID: 33503807 PMCID: PMC7912705 DOI: 10.3390/healthcare9020118] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/31/2020] [Accepted: 01/12/2021] [Indexed: 12/13/2022] Open
Abstract
Dentistry is a part of the field of medicine which is advocated in this digital revolution. The increasing trend in dentistry digitalization has led to the advancement in computer-derived data processing and manufacturing. This progress has been exponentially supported by the Internet of medical things (IoMT), big data and analytical algorithm, internet and communication technologies (ICT) including digital social media, augmented and virtual reality (AR and VR), and artificial intelligence (AI). The interplay between these sophisticated digital aspects has dramatically changed the healthcare and biomedical sectors, especially for dentistry. This myriad of applications of technologies will not only be able to streamline oral health care, facilitate workflow, increase oral health at a fraction of the current conventional cost, relieve dentist and dental auxiliary staff from routine and laborious tasks, but also ignite participatory in personalized oral health care. This narrative article review highlights recent dentistry digitalization encompassing technological advancement, limitations, challenges, and conceptual theoretical modern approaches in oral health prevention and care, particularly in ensuring the quality, efficiency, and strategic dental care in the modern era of dentistry.
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Affiliation(s)
- Muhammad Syafiq Alauddin
- Department of Conservative Dentistry and Prosthodontics, Faculty of Dentistry, Universiti Sains Islam Malaysia, Kuala Lumpur 56100, Malaysia
- Correspondence:
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Digital Approach for the Rehabilitation of the Edentulous Maxilla with Pterygoid and Standard Implants: The Static and Dynamic Computer-Aided Protocols. Methods Protoc 2020; 3:mps3040084. [PMID: 33371232 PMCID: PMC7768480 DOI: 10.3390/mps3040084] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 11/16/2022] Open
Abstract
A full-arch rehabilitation of the edentulous upper jaw without grafting procedures exploits the residual alveolar or the basal bone, with the necessity of long implants placed with a particular orientation. The precision in planning and placing the fixtures is fundamental to avoid clinical problems and to allow an acceptable connection with the prosthesis. The computer-aided implantology resulted in more accuracy than the traditional one, with a high standard of correspondence between the virtual project and the real outcome. This paper reports about the two different digital protocols, static and dynamic, as support to implant-borne prosthetic rehabilitation of edentulous maxillae. Two pterygoid and two/four anterior standard implants were seated in both cases by two different operators, without flap raising, and immediately loaded. This approach avoided the posterior cantilever by-passing the maxillary sinus and was adequately planned and realized without any surgical or prosthetic error. The two digital flow-charts were described step by step, underlining each other’s advantages and drawbacks compared to a free-hand approach.
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Lungu AJ, Swinkels W, Claesen L, Tu P, Egger J, Chen X. A review on the applications of virtual reality, augmented reality and mixed reality in surgical simulation: an extension to different kinds of surgery. Expert Rev Med Devices 2020; 18:47-62. [PMID: 33283563 DOI: 10.1080/17434440.2021.1860750] [Citation(s) in RCA: 51] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background: Research proves that the apprenticeship model, which is the gold standard for training surgical residents, is obsolete. For that reason, there is a continuing effort toward the development of high-fidelity surgical simulators to replace the apprenticeship model. Applying Virtual Reality Augmented Reality (AR) and Mixed Reality (MR) in surgical simulators increases the fidelity, level of immersion and overall experience of these simulators.Areas covered: The objective of this review is to provide a comprehensive overview of the application of VR, AR and MR for distinct surgical disciplines, including maxillofacial surgery and neurosurgery. The current developments in these areas, as well as potential future directions, are discussed.Expert opinion: The key components for incorporating VR into surgical simulators are visual and haptic rendering. These components ensure that the user is completely immersed in the virtual environment and can interact in the same way as in the physical world. The key components for the application of AR and MR into surgical simulators include the tracking system as well as the visual rendering. The advantages of these surgical simulators are the ability to perform user evaluations and increase the training frequency of surgical residents.
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Affiliation(s)
- Abel J Lungu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Wout Swinkels
- Computational Sensing Systems, Department of Engineering Technology, Hasselt University, Diepenbeek, Belgium
| | - Luc Claesen
- Computational Sensing Systems, Department of Engineering Technology, Hasselt University, Diepenbeek, Belgium
| | - Puxun Tu
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Jan Egger
- Graz University of Technology, Institute of Computer Graphics and Vision, Graz, Austria.,Graz Department of Oral &maxillofacial Surgery, Medical University of Graz, Graz, Austria.,The Laboratory of Computer Algorithms for Medicine, Medical University of Graz, Graz, Austria
| | - Xiaojun Chen
- Institute of Biomedical Manufacturing and Life Quality Engineering, State Key Laboratory of Mechanical System and Vibration, School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai, China
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Benmahdjoub M, van Walsum T, van Twisk P, Wolvius EB. Augmented reality in craniomaxillofacial surgery: added value and proposed recommendations through a systematic review of the literature. Int J Oral Maxillofac Surg 2020; 50:969-978. [PMID: 33339731 DOI: 10.1016/j.ijom.2020.11.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 11/11/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
This systematic review provides an overview of augmented reality (AR) and its benefits in craniomaxillofacial surgery in an attempt to answer the question: Is AR beneficial for craniomaxillofacial surgery? This review includes a description of the studies conducted, the systems used and their technical characteristics. The search was performed in four databases: PubMed, Cochrane Library, Embase, and Web of Science. All journal articles published during the past 11 years related to AR, mixed reality, craniomaxillofacial, and surgery were considered in this study. From a total of 7067 articles identified using AR- and surgery-related keywords, 39 articles were finally selected. Based on these articles, a classification of study types, surgery types, devices used, metrics reported, and benefits were collected. The findings of this review indicate that AR could provide various benefits, addressing the challenges of conventional navigation systems, such as hand-eye coordination and depth perception. However, three main concerns were raised while performing this study: (1) it is complicated to aggregate the metrics reported in the articles, (2) it is difficult to obtain statistical value from the current studies, and (3) user evaluation studies are lacking. This article concludes with recommendations for future studies by addressing the latter points.
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Affiliation(s)
- M Benmahdjoub
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands; Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
| | - T van Walsum
- Biomedical Imaging Group Rotterdam, Department of Radiology and Nuclear Medicine, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - P van Twisk
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - E B Wolvius
- Department of Oral and Maxillofacial Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Development of Simulation Methods in Biomedical Sciences - From Phantoms to Virtual Patients. SERBIAN JOURNAL OF EXPERIMENTAL AND CLINICAL RESEARCH 2020. [DOI: 10.2478/sjecr-2020-0051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Simulation is an imitation of the operation of a real process or system over time that is applied for a variety of purposes, including entertainment, education, training, system evaluation, and research. Medical simulation is an artificial presentation of real clinical situations, which is applied in education. Medical simulation allows the acquisition of clinical skills without the risk of harming the patient. Medical simulations have been developed and refined over the years-simulation models, cadavers, actors and robots have found wide application in medical training. Of more sophisticated simulation technologies, Virtual and Augmented Realities are used. The presence of science in the digital world is necessary in order to market the proven knowledge acquired in an adequate manner. The traditional teaching process, despite serious and thorough research, seems non-inspirational, and it is important that educators and teachers keep up with the times and provide students with the latest teaching and work methods.
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Palkovics D, Mangano FG, Nagy K, Windisch P. Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning. BMC Oral Health 2020; 20:351. [PMID: 33261592 PMCID: PMC7709443 DOI: 10.1186/s12903-020-01342-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/22/2020] [Indexed: 12/02/2022] Open
Abstract
Background In the regenerative treatment of intrabony periodontal defects, surgical strategies are primarily determined by defect morphologies. In certain cases, however, direct clinical measurements and intraoral radiographs do not provide sufficient information on defect morphologies. Therefore, the application of cone-beam computed tomography (CBCT) has been proposed in specific cases. 3D virtual models reconstructed with automatic thresholding algorithms have already been used for diagnostic purposes. The aim of this study was to utilize 3D virtual models, generated with a semi-automatic segmentation method, for the treatment planning of minimally invasive periodontal surgeries and to evaluate the accuracy of the virtual models, by comparing digital measurements to direct intrasurgical measurements. Methods Four patients with a total of six intrabony periodontal defects were enrolled in the present study. Two months following initial periodontal treatment, a CBCT scan was taken. The novel semi-automatic segmentation method was performed in an open-source medical image processing software (3D Slicer) to acquire virtual 3D models of alveolar and dental structures. Intrasurgical and digital measurements were taken, and results were compared to validate the accuracy of the digital models. Defect characteristics were determined prior to surgery with conventional diagnostic methods and 3D virtual models. Diagnostic assessments were compared to the actual defect morphology during surgery. Results Differences between intrasurgical and digital measurements in depth and width of intrabony components of periodontal defects averaged 0.31 ± 0.21 mm and 0.41 ± 0.44 mm, respectively. In five out of six cases, defect characteristics could not be assessed precisely with direct clinical measurements and intraoral radiographs. 3D models generated with the presented semi-automatic segmentation method depicted the defect characteristics correctly in all six cases. Conclusion It can be concluded that 3D virtual models acquired with the described semi-automatic segmentation method provide accurate information on intrabony periodontal defect morphologies, thus influencing the treatment strategy. Within the limitations of this study, models were found to be accurate; however, further investigation with a standardized validation process on a large number of participants has to be conducted.
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Affiliation(s)
- Daniel Palkovics
- Department of Periodontology, Semmelweis University, 1088 Szentkirályi Str. 47. 4th Floor, Budapest, Hungary.
| | - Francesco Guido Mangano
- Department of Prevention and Communal Dentistry, Sechenov First State Medical University, Bol'shaya Pirogovskaya Ulitsa, 19c1, Moscow, Russia
| | - Katalin Nagy
- Department of Oral Surgery, University of Szeged, Tisza L. Str. 64, Szeged, Hungary
| | - Peter Windisch
- Department of Periodontology, Semmelweis University, 1088 Szentkirályi Str. 47. 4th Floor, Budapest, Hungary
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Zorzal ER, Paulo SF, Rodrigues P, Mendes JJ, Lopes DS. An immersive educational tool for dental implant placement: A study on user acceptance. Int J Med Inform 2020; 146:104342. [PMID: 33310434 DOI: 10.1016/j.ijmedinf.2020.104342] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Tools for training and education of dental students can improve their ability to perform technical procedures such as dental implant placement. Shortage of training can negatively affect dental implantologists' performance during intraoperative procedures, resulting in lack of surgical precision and, consequently, inadequate implant placement, which may lead to unsuccessful implant supported restorations or other complications. OBJECTIVE We designed and developed IMMPLANT a virtual reality educational tool to assist implant placement learning, which allows users to freely manipulate 3D dental models (e.g., a simulated patient's mandible and implant) with their dominant hand while operating a touchscreen device to assist 3D manipulation. METHODS The proposed virtual reality tool combines an immersive head-mounted display, a small hand tracking device and a smartphone that are all connected to a laptop. The operator's dominant hand is tracked to quickly and coarsely manipulate either the 3D dental model or the virtual implant, while the non-dominant hand holds a smartphone converted into a controller to assist button activation and a greater input precision for 3D implant positioning and inclination. We evaluated IMMPLANT's usability and acceptance during training sessions with 16 dental professionals. RESULTS The conducted user acceptance study revealed that IMMPLANT constitutes a versatile, portable, and complementary tool to assist implant placement learning, as it promotes immersive visualization and spatial manipulation of 3D dental anatomy. CONCLUSIONS IMMPLANT is a promising virtual reality tool to assist student learning and 3D dental visualization for implant placement education. IMMPLANT may also be easily incorporated into training programs for dental students.
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Affiliation(s)
- Ezequiel Roberto Zorzal
- ICT/UNIFESP, Instituto de Ciência e Tecnologia, Universidade Federal de São Paulo, Brazil; INESC-ID Lisboa, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
| | | | - Pedro Rodrigues
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - José João Mendes
- Clinical Research Unit (CRU), Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Almada, Portugal
| | - Daniel Simões Lopes
- INESC-ID Lisboa, Instituto Superior Técnico, Universidade de Lisboa, Portugal.
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Dynamic Navigation for Zygomatic Implants: A Case Report about a Protocol with Intraoral Anchored Reference Tool and an Up-To-Date Review of the Available Protocols. Methods Protoc 2020; 3:mps3040075. [PMID: 33167345 PMCID: PMC7711909 DOI: 10.3390/mps3040075] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023] Open
Abstract
Dynamic Navigation is a computer-aided technology that allows the surgeon to track the grip instruments while preparing the implant site in real time based on radiological anatomy and accurate pre-operative planning. The support of this technology to the zygoma implant placement aims to reduce the risks and the errors associated with this complex surgical and prosthetic treatment. Various navigation systems are available to clinicians currently, distinguished by handling, reliability, and the associated economic and biological benefits and disadvantages. The present paper reports on the different protocols of dynamic navigations following a standard workflow in correlation with zygomatic implant supported rehabilitations and describes a case of maxillary atrophy successfully resolved with this technology. An innovative and minimally invasive dynamic navigation system, with the use of an intraoral anchored trust marker plate and a patient reference tool, has been adopted to support the accurate insertion of four zygomatic implants, which rapidly resolved maxillary atrophy from a 75-year-old male system. This approach provided an optimal implant placement accuracy reducing surgical invasiveness.
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Kalaivani G, Balaji VR, Manikandan D, Rohini G. Expectation and reality of guided implant surgery protocol using computer-assisted static and dynamic navigation system at present scenario: Evidence-based literature review. J Indian Soc Periodontol 2020; 24:398-408. [PMID: 33144766 PMCID: PMC7592620 DOI: 10.4103/jisp.jisp_92_20] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 05/15/2020] [Accepted: 06/14/2020] [Indexed: 11/25/2022] Open
Abstract
In the field of modern dentistry, ideal three-dimensional positioning of dental implant with optimal prosthetic fit offers successful long-term outcomes. To achieve such accurate implant placement, presurgical evaluation of hard and soft tissue matters the most. Their efforts can be attained using various application programs such as digital imaging, implant planning software, laboratory- or computer-assisted surgical guides, and dynamic navigation approach. To overcome different opinions and choices regarding guided surgery, this article explains an evidence-based literature review to assess its various outcomes and allowing informed choices before using various guided surgical techniques based on its expectation and reality outcomes. This highlights a clinician's choice to guide his successful implant surgery without causing distress in the midway of treatment. An online search was done on PubMed/Medline database to bring in accuracy to the expertise. This review includes reference of publications from 2000 to 2019, which is related to promising outcomes using computer-assisted static or dynamic navigation system for the placement of implant. Out of these, 809 were related to the computer-guided implant placement. Relevant papers were chosen in accordance with the inclusion and exclusion criteria. This review article contemplates to reflect the fact that computer-guided approach is considered to offer more predictable, safer, and faster implant placement with the predetermined final prosthetic outfit. Thus, digital planning and placing of dental implants in the correct position keep escalating to a higher achievement levels than a classical freehand approach. Nevertheless, this guided surgical approach also holds some errors and risks, which must be identified and rectified.
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Affiliation(s)
- Gunalan Kalaivani
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | | | - Dhanasekaran Manikandan
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - Govindasamy Rohini
- Department of Periodontology and Implant Dentistry, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Mladenovic R, Dakovic D, Pereira L, Matvijenko V, Mladenovic K. Effect of augmented reality simulation on administration of local anaesthesia in paediatric patients. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:507-512. [PMID: 32243051 DOI: 10.1111/eje.12529] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 03/21/2020] [Accepted: 03/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Augmented reality (AR) is a simulation of a three-dimensional environment created using hardware and software that provides the user with realistic experiences and ability to interact. The aim of the study was to evaluate the impact of AR simulator on the perception of learning and acute stress level in students administering local anaesthesia to paediatric patients relative to standard teaching methods. MATERIAL AND METHODS The prospective study included 21 fourth- and fifth-year students enrolled in 5-year dental programme. In addition to conventional training, the students of the study group used the augmented reality simulator in a dental office 2 hours weekly in 2 weeks. The level of salivary cortisol was measured before and after the anaesthetic procedure as one of the indicators of acute stress. RESULTS A statistically significant shorter time to perform infiltrative anaesthesia technique for the anterior superior alveolar nerve was observed in students using the AR technique (28.91 ± 9.06 seconds in the study group and 39.80 ± 9.29 seconds in the control group). The level of cortisol before and after anaesthesia was statistically significant in all subjects (cortisol concentration was 0.53 μg/dL before anaesthesia and 2.44 μg/dL after the procedure); however, there was no statistically significant difference between the groups. CONCLUSION The AR concept may influence better manipulation and control of the syringe in students administering their first anaesthetic injection to paediatric patients, but may not reduce acute stress.
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Affiliation(s)
- Rasa Mladenovic
- Faculty of Medicine, Department for Dentistry, University in Pristina, Kosovska Mitrovica, Serbia
| | - Dragana Dakovic
- Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
| | | | - Vladimir Matvijenko
- Faculty of Medicine, Department for Dentistry, University in Pristina, Kosovska Mitrovica, Serbia
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Salem S, Cooper J, Schneider J, Croft H, Munro I. Student Acceptance of Using Augmented Reality Applications for Learning in Pharmacy: A Pilot Study. PHARMACY 2020; 8:pharmacy8030122. [PMID: 32708150 PMCID: PMC7560130 DOI: 10.3390/pharmacy8030122] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/03/2020] [Accepted: 07/16/2020] [Indexed: 12/30/2022] Open
Abstract
Creating engaging learning experiences that are easy to use and support the different learning requirements of university students is challenging. However, improvements in simulation technologies, such as augmented reality (AR) and virtual reality (VR), are making such changes possible. The aim of this study is to use a mobile-based AR technology to develop an interactive learning module about contraceptive devices and medicines and to measure its acceptability and usability by undergraduate pharmacy students. The learning module comprising AR images of contraceptive medicines, case studies relating to their use and a series of directed questions was completed by 33 pharmacy students. Students answered a survey to collect information about the usability and acceptability of AR for learning. The results show that the majority of students reported that AR is a useful resource for learning about medicines compared to more traditional methods, such as didactic lectures and tutorials. Students indicated that the AR application was easy to use and improved their knowledge of medicines. These findings suggest that AR technology is a useful tool to create engaging and easy to use learning experiences for university students.
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Zafar S, Zachar JJ. Evaluation of HoloHuman augmented reality application as a novel educational tool in dentistry. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2020; 24:259-265. [PMID: 31899840 DOI: 10.1111/eje.12492] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 11/26/2019] [Accepted: 12/31/2019] [Indexed: 05/16/2023]
Abstract
AIMS To investigate dental student's perception of the augmented reality (AR) head and neck anatomy application and to determine whether the learning environment was beneficial for students compared with traditional cadaver learning. METHODS A total of 88 students participated in a self-administered questionnaire prior to and after the use of AR. This was conducted during anatomy classes for second-year dentistry students. Descriptive data analysis was performed to determine the perceptions of experience gained through AR. RESULTS The study revealed that over two-thirds of participants perceived that it would assist in their learning with 52.3% of participants who agreed and 35.2% of participants who strongly agreed. After the use of HoloHuman, it was found that 43.5% of participants agreed that the 3D anatomical structures improved their understanding of anatomy and 36.5% agreed that they felt more confident about their anatomy skills. The results also demonstrated that only 34.1% agreed that it added value in training compared with relying solely on traditional methods. Overall, 75.3% of participants agreed that HoloHuman teaching should not replace traditional cadaver training. CONCLUSION This study suggested that the use of AR offers an additional mean of dental anatomy training; however, it cannot be used as a replacement for traditional modes of cadaver anatomy training. AR has the potential to be used as an adjunct tool in the learning of dental head and neck anatomy as it has demonstrated increased student engagement and enjoyment; however, limitations with the device still remain.
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Affiliation(s)
- Sobia Zafar
- Discipline Lead for Paediatric Dentistry, School of Dentistry, The University of Queensland, Brisbane, Qld, Australia
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Amornvit P, Sanohkan S. The Accuracy of Digital Face Scans Obtained from 3D Scanners: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E5061. [PMID: 31842255 PMCID: PMC6950499 DOI: 10.3390/ijerph16245061] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2019] [Revised: 12/04/2019] [Accepted: 12/05/2019] [Indexed: 12/19/2022]
Abstract
Face scanners promise wide applications in medicine and dentistry, including facial recognition, capturing facial emotions, facial cosmetic planning and surgery, and maxillofacial rehabilitation. Higher accuracy improves the quality of the data recorded from the face scanner, which ultimately, will improve the outcome. Although there are various face scanners available on the market, there is no evidence of a suitable face scanner for practical applications. The aim of this in vitro study was to analyze the face scans obtained from four scanners; EinScan Pro (EP), EinScan Pro 2X Plus (EP+) (Shining 3D Tech. Co., Ltd. Hangzhou, China), iPhone X (IPX) (Apple Store, Cupertino, CA, USA), and Planmeca ProMax 3D Mid (PM) (Planmeca USA, Inc. IL, USA), and to compare scans obtained from various scanners with the control (measured from Vernier caliper). This should help to identify the appropriate scanner for face scanning. A master face model was created and printed from polylactic acid using the resolution of 200 microns on x, y, and z axes and designed in Rhinoceros 3D modeling software (Rhino, Robert McNeel and Associates for Windows, Washington DC, USA). The face models were 3D scanned with four scanners, five times, according to the manufacturer's recommendations; EinScan Pro (Shining 3D Tech. Co., Ltd. Hangzhou, China), EinScan Pro 2X Plus (Shining 3D Tech. Co., Ltd. Hangzhou, China) using Shining Software, iPhone X (Apple Store, Cupertino, CA, USA) using Bellus3D Face Application (Bellus3D, version 1.6.2, Bellus3D, Inc. Campbell, CA, USA), and Planmeca ProMax 3D Mid (PM) (Planmeca USA, Inc. IL, USA). Scan data files were saved as stereolithography (STL) files for the measurements. From the STL files, digital face models are created in the computer using Rhinoceros 3D modeling software (Rhino, Robert McNeel and Associates for Windows, Washington DC, USA). Various measurements were measured five times from the reference points in three axes (x, y, and z) using a digital Vernier caliper (VC) (Mitutoyo 150 mm Digital Caliper, Mitutoyo Co., Kanagawa, Japan), and the mean was calculated, which was used as the control. Measurements were measured on the digital face models of EP, EP+, IPX, and PM using Rhinoceros 3D modeling software (Rhino, Robert McNeel and Associates for Windows, Washington DC, USA). The descriptive statistics were done from SPSS version 20 (IBM Company, Chicago, USA). One-way ANOVA with post hoc using Scheffe was done to analyze the differences between the control and the scans (EP, EP+, IPX, and PM). The significance level was set at p = 0.05. EP+ showed the highest accuracy. EP showed medium accuracy and some lesser accuracy (accurate until 10 mm of length), but IPX and PM showed the least accuracy. EP+ showed accuracy in measuring the 2 mm of depth (diameter 6 mm). All other scanners (EP, IPX, and PM) showed less accuracy in measuring depth. Finally, the accuracy of an optical scan is dependent on the technology used by each scanner. It is recommended to use EP+ for face scanning.
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Affiliation(s)
| | - Sasiwimol Sanohkan
- Department of Prosthetic Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand;
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Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Navigation for Dental Implant Placement: An In Vitro Study. J Clin Med 2019; 8:jcm8122123. [PMID: 31810351 PMCID: PMC6947513 DOI: 10.3390/jcm8122123] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 11/28/2019] [Accepted: 11/28/2019] [Indexed: 12/28/2022] Open
Abstract
Aim: To analyze the accuracy capability of two computer-aided navigation procedures for dental implant placement. Materials and Methods: A total of 40 dental implants were selected, which were randomly distributed into two study groups, namely, group A, consisting of those implants that were placed using a computer-aided static navigation system (n = 20) (guided implant (GI)) and group B, consisting of those implants that were placed using a computer-aided dynamic navigation system (n = 20) (navigation implant (NI)). The placement of the implants from group A was performed using surgical templates that were designed using 3D implant-planning software based on preoperative cone-beam computed tomography (CBCT) and a 3D extraoral surface scan, and the placement of group B implants was planned and performed using the dynamic navigation system. After placing the dental implants, a second CBCT was performed and the degree of accuracy of the planning and placement of the implants was analyzed using therapeutic planning software and Student’s t-test. Results: The paired t-test revealed no statistically significant differences between GI and NI at the coronal (p = 0.6535) and apical (p = 0.9081) levels; however, statistically significant differences were observed between the angular deviations of GI and NI (p = 0.0272). Conclusion: Both computer-aided static and dynamic navigation procedures allow accurate implant placement.
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Ayoub A, Pulijala Y. The application of virtual reality and augmented reality in Oral & Maxillofacial Surgery. BMC Oral Health 2019; 19:238. [PMID: 31703708 PMCID: PMC6839223 DOI: 10.1186/s12903-019-0937-8] [Citation(s) in RCA: 122] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Accepted: 10/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery. Methods We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included. Results We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training. Conclusion Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education.
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Affiliation(s)
- Ashraf Ayoub
- Scottish Craniofacial Research Group, Glasgow University MVLS College, School of Medicine, Dentistry and Nursing, Glasgow University Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
| | - Yeshwanth Pulijala
- Scottish Craniofacial Research Group, Glasgow University MVLS College, School of Medicine, Dentistry and Nursing, Glasgow University Dental School, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK
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