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.
Department of Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Comput Biol Med. 2023 Nov;166:107560. doi: 10.1016/j.compbiomed.2023.107560. Epub 2023 Oct 11.
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.
背景：成功的牙种植手术的关键是沿着术前规划的路径准确地放置种植体。手术导航系统的应用可以显著提高种植体的安全性和准确性。然而，由于术者频繁地在手术部位和电脑屏幕之间切换视线，这可能会导致一些问题，预计通过引入混合现实技术，通过佩戴 HoloLens 设备，将虚拟三维（3D）图像与手术部位的实际情况在同一视野中对齐，可以解决这个问题。
方法：本研究利用混合现实技术增强牙种植手术导航。我们的第一步是从术前锥形束 CT（CBCT）图像重建虚拟 3D 模型。然后，我们使用导航设备和 HoloLens 相机获得物体之间的相对位置。通过虚拟-实际配准算法，通过 HoloLens-跟踪器配准获得 HoloLens 设备和导航跟踪器之间的变换矩阵，通过图像-模型配准获得虚拟模型和患者模型之间的变换矩阵。此外，手术钻头校准算法辅助获得手术钻头和患者模型之间的变换矩阵。这些算法允许在导航设备下实时跟踪手术钻头相对于患者模型的位置和方向。借助 HoloLens 2，虚拟 3D 图像和实际患者模型可以精确对齐，为术者提供清晰的植入物路径可视化。
结果：使用 30 个患者模型进行了幻影实验，共植入 102 颗牙种植体。实际种植体路径与术前计划种植体路径的比较表明，我们的系统实现了冠向偏差 1.507±0.155mm、根尖向偏差 1.542±0.143mm 和角向偏差 3.468±0.339°。该偏差与导航引导的牙种植体放置无显著差异，但优于徒手牙种植体放置。
结论：我们提出的系统实现了术前计划的牙种植体路径与患者模型的集成，有助于术者在传统牙种植术中达到足够的准确性。此外，该系统有望在进一步的研究中应用于动物和尸体实验。
Comput Methods Programs Biomed. 2024-6
Int J Oral Maxillofac Implants. 2018
Comput Biol Med. 2023-3
Med Biol Eng Comput. 2018-7-2
Oral Maxillofac Surg Clin North Am. 2019-11
Int J Comput Assist Radiol Surg. 2024-9
Zotero 插件