Computer-assisted surgery with markerless augmented reality for the surgical removal of mandibular odontogenic cysts: report of two clinical cases.

Odontogenic cysts are commonly seen in clinical practice. Surgical enucleation of these cysts becomes challenging when they form adjacent to anatomically important structures. Recently, computer-assisted surgery using computer-aided preoperative simulation and augmented reality (AR) has been applied in oral and maxillofacial surgery. The authors have introduced a new AR system that eliminates the need for markers and uses image recognition of the teeth to overlay the surgical field with preoperative surgical simulation images. This report describes two cases of cystectomy performed using an AR-assisted system, one for recurrent odontogenic keratocyst and the other for a dentigerous cyst. The teeth were scanned using a 3D intraoral scanner, while the face was scanned using a computed tomography scanner. A 3D reconstructed image of the mandible was generated, and a dentofacial skeleton model was designed using the intraoral and CT scan data. A camera was used to capture the clinical image and validate the AR. Two cystectomy cases performed using the AR-assisted system and preoperative planning are reported. This new AR system, which eliminates the need for markers and uses image recognition of the teeth to overlay the surgical field with preoperative surgical simulation images, has the potential to provide more accurate and efficient guidance during surgery.