Review on Augmented Reality in Oral and Cranio-Maxillofacial Surgery: Toward 'Surgery-Specific' Head-Up Displays

In recent years, there has been an increasing interest towards the augmented reality as applied to the surgical field. We conducted a systematic review of literature classifying the augmented reality applications in oral and cranio-maxillofacial surgery (OCMS) in order to pave the way to future solutions that may ease the adoption of AR guidance in surgical practice. Publications containing the terms 'augmented reality' AND 'maxillofacial surgery', and the terms 'augmented reality' AND 'oral surgery' were searched in the PubMed database. Through the selected studies, we performed a preliminary breakdown according to general aspects, such as surgical subspecialty, year of publication and country of research; then, a more specific breakdown was provided according to technical features of AR-based devices, such as virtual data source, visualization processing mode, tracking mode, registration technique and AR display type. The systematic search identified 30 eligible publications. Most studies (14) were in orthognatic surgery, the minority (2) concerned traumatology, while 6 studies were in oncology and 8 in general OCMS. In 8 of 30 studies the AR systems were based on a head-mounted approach using smart glasses or headsets. In most of these cases (7), a video-see-through mode was implemented, while only 1 study described an optical-see-through mode. In the remaining 22 studies, the AR content was displayed on 2D displays (10), full-parallax 3D displays (6) and projectors (5). In 1 case the AR display type is not specified. AR applications are of increasing interest and adoption in oral and cranio-maxillofacial surgery, however, the quality of the AR experience represents the key requisite for a successful result. Widespread use of AR systems in the operating room may be encouraged by the availability of 'surgery-specific' head-mounted devices that should guarantee the accuracy required for surgical tasks and the optimal ergonomics

Accuracy of Surgical Robot System Compared to Surgical Guide for Dental Implant Placement: A Pilot Study

Purpose: This study aimed to evaluate the tracking accuracy of a robot-guided implant surgery system and compare the spatial accuracy of robot-assisted implant surgery with that of static stentguided implant surgery for implant placement. Materials and Methods: The tracking accuracy of the robot system was evaluated by measuring the discrepancy between the robot arm and actual programmed position. Dental implants were placed on 3D printed human phantom models using static stent-guided and robot-assisted surgeries. The top, apex, angular, and depth deviations of the placed implant positions were measured relative to the planned position, and the values were compared between the robot and surgical guide groups. The results were analyzed using the Mann-Whitney U test (α = .05). Results: The tracking accuracy of the robot system showed a linear deviation of 0.13 ± 0.04 mm and an angular deviation of 0.77 ± 0.02° at the drill tip. Deviations at the top and apex of the implants were 0.61 ± 0.29 mm and 0.50 ± 0.14 mm in the robot group and of 0.49 ± 0.39 mm and 0.72 ± 0.39 mm in the surgical guide group, respectively. Angular and depth deviations were of 2.38 ± 0.62° and 0.17 ± 0.12 mm, respectively, in the robot group, and of 3.16 ± 2.36° and 0.15 ± 0.11 mm, respectively, in the surgical guide group. No statistically significant differences were found between the robotic and surgical guide groups (p > .05). Conclusion: The accuracy in implant placement using robot-assisted implant surgery was comparable to that of static-guided surgery. Robot-assisted implant surgery and static-guided surgery tended to result in minor deviations at the apex and top of the implants, respectively.ope

Optical accuracy assessment of robotically assisted dental implant surgery

BACKGROUND: Static and dynamic dental implant guidance systems have established themselves as effective choices that result in predictable and relatively accurate dental implant placement. Generally, studies assess this accuracy using a postoperative CBCT, which has disadvantages such as additional radiation exposure for the patient. This pilot study proposed a scanbody-agnostic method of implant position assessment using intraoral scanning technology and applied it as an accuracy test of robotically assisted dental implant placement using the Neocis Yomi. MATERIALS AND METHODS: All of the robotically assisted dental implant surgery was performed in the Postdoctoral Periodontology clinic at Boston University Henry M. Goldman School of Dental Medicine. Completely edentulous patients were excluded. A total of eleven (11) implants were included in the study, eight (8) of which were fully guided. An optical impression of each implant position was obtained using a CEREC Omnicam (SW 5.1) intraoral scanner. Each sample used either a DESS Lab Scan Body or an Elos Accurate Scan Body as a means to indirectly index the position of the implant. A comparison of planned implant position versus executed surgical implant position was performed for each placement using Geomagic Control X software. Global positional and angular deviations were quantified using a proposed scanbody-agnostic method. Intraoral directionality of deviation was visually qualified by the author (D.K). RESULTS: Mean global positional deviations at the midpoints of the top of each scanbody were 1.7417 mm in the partially guided samples and 1.1300 mm in the fully guided samples. Mean global positional deviations at the midpoints of the restorative platforms of each implant were 1.3142 mm in the partially guided sample and 1.27045 mm in the fully guided samples. Mean global positional deviations at the midpoints of the apex of each implant were 1.455 mm in the partially guided samples and 1.574 mm in the fully guided samples. Mean angular deviations were 3.7492 degrees in the partially guided samples and 2.6432 degrees in the fully guided samples. CONCLUSION: Within the sample size limitations, robotically assisted dental implant surgery offers similar implant placement accuracy compared to published static and dynamic implant placement guidance systems. Intraoral optical assessment of dental implant position used in this study allows comparable analysis to other methods without requiring additional exposure to radiation and should be considered the default method of assessing guidance accuracy

Image-Guided Robotic Dental Implantation With Natural-Root-Formed Implants

Dental implantation is now recognized as the standard of the care for tooth replacement. Although many studies show high short term survival rates greater than 95%, long term studies (\u3e 5 years) have shown success rates as low as 41.9%. Reasons affecting the long term success rates might include surgical factors such as limited accuracy of implant placement, lack of spacing controls, and overheating during the placement. In this dissertation, a comprehensive solution for improving the outcome of current dental implantation is presented, which includes computer-aided preoperative planning for better visualization of patient-specific information and automated robotic site-preparation for superior placement and orientation accuracy. Surgical planning is generated using patient-specific three-dimensional (3D) models which are reconstructed from Cone-beam CT images. An innovative image-guided robotic site-preparation system for implants insertion is designed and implemented. The preoperative plan of the implant insertion is transferred into intra-operative operations of the robot using a two-step registration procedure with the help of a Coordinate Measurement Machine (CMM). The natural-root implants mimic the root structure of natural teeth and were proved by Finite Element Method (FEM) to provide superior stress distribution than current cylinder-shape implants. However, due to their complicated geometry, manual site-preparation for these implants cannot be accomplished. Our innovative image-guided robotic implantation system provides the possibility of using this advanced type of implant. Phantom experiments with patient-specific jaw models were performed to evaluate the accuracy of positioning and orientation. Fiducial Registration Error (FRE) values less than 0.20 mm and final Target Registration Error (TRE) values after the two-step registration of 0.36±0.13 mm (N=5) were achieved. Orientation error was 1.99±1.27° (N=14). Robotic milling of the natural-root implant shape with single- and double-root was also tested, and the results proved that their complicated volumes can be removed as designed by the robot. The milling time for single- and double-root shape was 177 s and 1522 s, respectively

Augmented Reality

Augmented Reality (AR) is a natural development from virtual reality (VR), which was developed several decades earlier. AR complements VR in many ways. Due to the advantages of the user being able to see both the real and virtual objects simultaneously, AR is far more intuitive, but it's not completely detached from human factors and other restrictions. AR doesn't consume as much time and effort in the applications because it's not required to construct the entire virtual scene and the environment. In this book, several new and emerging application areas of AR are presented and divided into three sections. The first section contains applications in outdoor and mobile AR, such as construction, restoration, security and surveillance. The second section deals with AR in medical, biological, and human bodies. The third and final section contains a number of new and useful applications in daily living and learning

Cultured Mucosal Substitutes; from Lab Bench towards Bedside?

__Abstract__ Oral cancer is the sixth most common cancer in the world. It accounts for approximately 4% of all cancers and 2% of all cancer deaths worldwide. Malignant tumors of the oral cavity account for approximately 30% of all head and neck cancers. With an incidence rate of invasive lip and oral cavity tumors in The Netherlands rising to 6.6%, oral cancer is a common malignancy that often requires resection of the tumor followed by reconstruction

3D Innovations in Personalized Surgery

Current practice involves the use of 3D surgical planning and patient-specific solutions in multiple surgical areas of expertise. Patient-specific solutions have been endorsed for several years in numerous publications due to their associated benefits around accuracy, safety, and predictability of surgical outcome. The basis of 3D surgical planning is the use of high-quality medical images (e.g., CT, MRI, or PET-scans). The translation from 3D digital planning toward surgical applications was developed hand in hand with a rise in 3D printing applications of multiple biocompatible materials. These technical aspects of medical care require engineers’ or technical physicians’ expertise for optimal safe and effective implementation in daily clinical routines.The aim and scope of this Special Issue is high-tech solutions in personalized surgery, based on 3D technology and, more specifically, bone-related surgery. Full-papers or highly innovative technical notes or (systematic) reviews that relate to innovative personalized surgery are invited. This can include optimization of imaging for 3D VSP, optimization of 3D VSP workflow and its translation toward the surgical procedure, or optimization of personalized implants or devices in relation to bone surgery