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Digital Hybrid Model Preparation for Virtual Planning of Reconstructive Dentoalveolar Surgical Procedures
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Augmented Reality-Guided Apicoectomy Based on Maxillofacial CBCT Scans.

Bernhard Remschmidt1,2, Marcus Rieder1,2, Christina Gsaxner3

  • 1Division of Oral and Maxillofacial Surgery, Department of Dental Medicine and Oral Health, Medical University of Graz, 8036 Graz, Austria.

Diagnostics (Basel, Switzerland)
|October 14, 2023
PubMed
Summary

This study investigates the use of a head-mounted augmented reality device to assist surgeons during root-end surgery. By overlaying 3D scans onto the surgical field, the technology aims to improve precision and reduce errors. Researchers tested the system on cadaver specimens and found the device easy to use and efficient for clinical tasks. The findings suggest that this technology could become a standard tool for improving surgical outcomes in dental procedures.

Keywords:
apicoectomyaugmented realitycomputer-assistedcone beam computed tomographyendodontic surgeryroot-end resectionsurgerydigital dentistrysurgical navigation3D imagingmaxillofacial imaging

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Area of Science:

  • Oral and maxillofacial surgery research within Augmented Reality-Guided Apicoectomy clinical workflows
  • Digital dentistry and imaging diagnostics

Background:

Current surgical techniques for root-end procedures often face challenges regarding anatomical visualization and precision. Surgeons frequently encounter difficulties when navigating complex bone structures during these delicate operations. Prior research has shown that traditional imaging methods provide limited real-time guidance during the actual intervention. That uncertainty drove the development of advanced visualization aids to assist medical professionals. No prior work had resolved the integration of head-mounted displays within this specific dental context. This gap motivated the exploration of immersive digital overlays to enhance spatial awareness. Researchers have long sought ways to minimize accidental damage to surrounding tissues during these interventions. This investigation addresses the need for improved technical support in modern dental practice.

Purpose Of The Study:

This study aims to evaluate the intraoperative feasibility and usability of an augmented reality device during root-end surgery. The researchers sought to determine if digital overlays could assist clinicians in navigating complex anatomical structures. This investigation addresses the specific problem of iatrogenic complications that often arise during these delicate dental procedures. The team wanted to understand if current hardware could be effectively integrated into standard surgical workflows. Motivation for this work stems from the need for better visual guidance to improve patient safety. No prior work had fully assessed the practical application of this specific head-mounted display in this context. The authors intended to provide empirical data on both the efficiency and the user experience of the technology. This research serves as a foundation for understanding how digital tools can enhance surgical precision in maxillofacial environments.

Main Methods:

The investigators designed an experimental study to assess the performance of a head-mounted display. Three experienced clinicians performed a series of twelve procedures on human cadaver heads. The review approach involved integrating preoperative imaging data into the augmented reality hardware. Each participant completed four distinct operations to ensure a robust data set. The team recorded the time required for both setup and the actual surgical intervention. They also administered a standardized usability questionnaire to capture subjective feedback from the operators. This quantitative assessment allowed for a comparison of performance across different surgeons. The methodology focused on evaluating the practical application of digital overlays in a controlled laboratory setting.

Main Results:

The primary finding demonstrates that the augmented reality system is highly feasible for surgical guidance. The average time required to prepare the device was 162 seconds. The actual surgical procedure lasted an average of 9 minutes. Statistical analysis revealed no significant differences in performance between the three participating surgeons. The usability assessment yielded a mean score of 80.4 on the standardized scale. This score indicates an excellent level of user satisfaction with the technology. The study successfully completed twelve operations across six cadaver specimens. These results suggest that the digital guidance system provides a reliable and efficient tool for dental professionals.

Conclusions:

The authors propose that head-mounted digital overlays offer a viable path for improving surgical precision. Their synthesis suggests that this technology integrates well into existing workflows for root-end procedures. The evidence indicates that practitioners can achieve high levels of comfort while using these systems. These findings imply that such tools could reduce the risk of unintended tissue damage during operations. The researchers advocate for the adoption of these devices to streamline complex dental tasks. Their work highlights the potential for digital guidance to become a standard component of surgical care. The data supports the claim that these systems are both practical and easy to operate. Future clinical adoption may benefit from the simplicity demonstrated in this experimental setup.

The researchers utilized the HoloLens 2 to overlay preoperative imaging data onto the surgical field. This system allows clinicians to view 3D anatomical structures in real-time, which helps them navigate bone tissue more accurately compared to traditional visual inspection alone.

The team employed the System Usability Scale to quantify user experience. This standardized questionnaire assesses perceived ease of use, with the device achieving a mean score of 80.4, which the authors categorize as an excellent level of performance for clinical environments.

The study required human cadaver head specimens to simulate real-world conditions. These biological models are necessary to replicate the anatomical constraints and tissue density that surgeons face, ensuring the guidance system functions correctly before any application in living patients.

The researchers utilized preoperative cone beam computed tomography scans to generate the digital overlays. These high-resolution images are essential for creating the 3D models that the augmented reality device projects onto the surgical site during the operation.

The team measured the preparation time, which averaged 162 seconds, and the surgical duration, which averaged 9 minutes. These metrics demonstrate the efficiency of the workflow, showing that the digital guidance does not significantly hinder the speed of the operation.

The authors suggest that these systems are suitable for routine implementation in clinical settings. They propose that the simplicity and practicality of the device make it a strong candidate for improving standard surgical outcomes in dental offices.