Pham Dang Nathalie, Chandelon Kilian, Barthélémy Isabelle, Devoize Laurent, Bartoli Adrien
Department of Oral and Maxillofacial surgery, NHE - CHU de Clermont-Ferrand, Université d'Auvergne, Clermont-Ferrand 63003, France; EnCoV, Institut Pascal, UMR 6602, CNRS/UBP/SIGMA, EnCoV, 63000, Clermont-Ferrand, France; UMR Inserm/UdA, U1107, Neuro-Dol, Trigeminal Pain and Migraine, Université d'Auvergne, Clermont-Ferrand 63003, France.
EnCoV, Institut Pascal, UMR 6602, CNRS/UBP/SIGMA, EnCoV, 63000, Clermont-Ferrand, France.
J Stomatol Oral Maxillofac Surg. 2021 Sep;122(4):338-342. doi: 10.1016/j.jormas.2021.05.012. Epub 2021 Jun 1.
The advent of digital medical imaging, medical image analysis and computer vision has opened the surgeon horizons with the possibility to add virtual information to the real operative field. For oral and maxillofacial surgeons, overlaying anatomical structures to protect (such as teeth, sinus floors, inferior and superior alveolar nerves) or to remove (such as cysts, tumours, impacted teeth) presents a real clinical interest.
Through this work, we propose a proof-of-concept markerless augmented reality system for oral and maxillofacial surgery, where a virtual scene is generated preoperatively and mixed with reality to reveal the location of hidden anatomical structures intraoperatively. We devised a computer software to process still video frames of the operating field and to display them on the operating room screens.
Firstly, we give a description of the proposed system, where virtuality aligns with reality without artificial markers. The dental occlusion plan analysis and cusps detection allow us to initialise the alignment process. Secondly, we validate the feasibility with an experimental approach on a 3D printed jaw phantom and an ex-vivo pig jaw. Thirdly, we evaluate the potential clinical benefit on a patient.
this proof-of-concept highlights the feasibility and the interest of augmented reality for hidden anatomical structures visualisation without artificial markers.
数字医学成像、医学图像分析和计算机视觉的出现，为外科医生带来了新的视野，使他们有可能在真实手术视野中添加虚拟信息。对于口腔颌面外科医生来说，叠加需要保护的解剖结构（如牙齿、窦底、上下牙槽神经）或需要切除的结构（如囊肿、肿瘤、阻生牙）具有实际临床意义。
通过这项工作，我们提出了一种用于口腔颌面外科手术的无标记增强现实系统概念验证，术前生成虚拟场景并与现实混合，以在术中揭示隐藏解剖结构的位置。我们设计了一个计算机软件来处理手术视野的静态视频帧，并将其显示在手术室屏幕上。
首先，我们描述了所提出的系统，其中虚拟与现实无需人工标记即可对齐。牙合平面分析和牙尖检测使我们能够初始化对齐过程。其次，我们通过在3D打印颌骨模型和离体猪颌骨上的实验方法验证了可行性。第三，我们评估了对一名患者的潜在临床益处。
这一概念验证突出了无人工标记增强现实用于隐藏解剖结构可视化的可行性和意义。
