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Related Experiment Video

Updated: May 27, 2026

Dynamic Navigation for Dental Implant Placement
05:42

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Published on: September 13, 2022

Do image modality and registration method influence the accuracy of craniofacial navigation?

Gerlig Widmann1, Antoniette Zangerl, Peter Schullian

  • 1SIP-Department for Microinvasive Therapy, Medical University of Innsbruck, Innsbruck, Austria. gerlig.widmann@i-med.ac.at

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
|November 15, 2011
PubMed
Summary

Cone-beam computed tomography (CBCT) and intraoperative multislice spiral computed tomography (MSCT) offer comparable accuracy for navigated surgery. Bone markers are most accurate, but registration templates and external frames are viable alternatives for CBCT.

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Area of Science:

  • Medical imaging
  • Surgical navigation
  • Craniofacial imaging

Background:

  • Cone-beam computed tomography (CBCT) is increasingly utilized in craniofacial imaging.
  • Its potential for navigated surgery necessitates accuracy evaluation.
  • Comparison with multislice spiral computed tomography (MSCT) is crucial.

Purpose of the Study:

  • To assess the accuracy of various registration techniques using CBCT.
  • To compare CBCT accuracy with intraoperative and diagnostic MSCT for navigated surgery.

Main Methods:

  • High-resolution images of a skull phantom were acquired using two CBCT machines and two MSCT scanners.
  • Registration accuracy was evaluated using bone markers, a registration template, and an external registration frame with an optical navigation system.
  • Target Registration Errors (TREs) were statistically analyzed.

Main Results:

  • Mean TREs ranged from 1.27 ± 0.52 mm (intraoperative MSCT) to 1.67 ± 0.65 mm (CBCT ILUMA).
  • CBCT (KaVo 3D eXam) showed no significant difference compared to MSCTs.
  • The ILUMA CBCT exhibited significantly higher TREs (P < .001) due to marginal imaging of the external registration frame.

Conclusions:

  • CBCT and intraoperative MSCT demonstrate accuracy comparable to diagnostic MSCT in navigated surgery.
  • Bone markers represent the gold standard for registration accuracy.
  • Registration templates and external registration frames are effective alternatives, with large-field CBCT recommended when using only external frames.