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颞下颌关节关节腔穿刺术中的增强现实技术——一项评估性临床研究。

Augmented Reality in Temporomandibular Joint Arthrocentesis - An Evaluative Clinical Study.

作者信息

Shah Jigna S, Poojary Manish K

机构信息

Department of Oral Medicine and Radiology, Government Dental College and Hospital, Ahmedabad, Gujarat, India.

出版信息

Ann Maxillofac Surg. 2025 Jan-Jun;15(1):78-82. doi: 10.4103/ams.ams_45_24. Epub 2025 Apr 29.

DOI:10.4103/ams.ams_45_24
PMID:40765863
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12321183/
Abstract

INTRODUCTION

Augmented reality (AR) combines computer-generated images, audios and videos on a screen with real-life scenes. Arthrocentesis is the lavage of the temporomandibular joint (TMJ) using sterile needles and sterile irrigants which requires precise puncture by a needle to the upper joint compartment. The aim of the study was to develop an AR system to identify the puncture point for TMJ arthrocentesis with direct access to the upper compartment of the joint.

MATERIALS AND METHODS

Two cases diagnosed with chronic recurrent dislocation of TMJ were selected for the study. A three-dimensional virtual model was reconstructed from cone-beam computed tomography (CBCT) images of a patient. The AR visualisation was created by developing an Android app which superimposed the virtual model and the TMJ in real time. The skin puncture point was marked on the skin, and the needle was guided to the upper compartment of the joint using this superimposed view to perform TMJ arthrocentesis.

RESULTS

Puncture with the AR method was successful in both the cases with direct access to the upper compartment of TMJ. Pain had reduced completely in both cases during 30- and 60-day follow-up periods; maximum mouth opening had reduced by an average of 4.33 mm after 60 days postoperatively, and clicking sound was completely absent after 14-day follow-up period.

DISCUSSION

AR could potentially enhance the accuracy and effectiveness of TMJ arthrocentesis by providing precise needle guidance and reducing the need for multiple punctures. However, the limitations must be addressed as well.

摘要

引言

增强现实（AR）将计算机生成的图像、音频和视频与现实场景相结合。关节穿刺术是使用无菌针头和无菌冲洗液对颞下颌关节（TMJ）进行灌洗，这需要用针头精确穿刺到关节上腔。本研究的目的是开发一种AR系统，以确定颞下颌关节穿刺术的穿刺点，直接进入关节上腔。

材料与方法

选择2例诊断为颞下颌关节慢性复发性脱位的病例进行研究。从一名患者的锥形束计算机断层扫描（CBCT）图像重建三维虚拟模型。通过开发一个安卓应用程序创建AR可视化，该应用程序实时叠加虚拟模型和颞下颌关节。在皮肤上标记皮肤穿刺点，并使用这种叠加视图将针头引导至关节上腔，以进行颞下颌关节穿刺术。

结果

采用AR方法穿刺在两例中均成功，直接进入颞下颌关节上腔。在30天和60天的随访期间，两例患者的疼痛均完全减轻；术后60天最大开口度平均减少4.33mm，随访14天后弹响完全消失。

讨论

AR通过提供精确的针头引导和减少多次穿刺的需要，有可能提高颞下颌关节穿刺术的准确性和有效性。然而，其局限性也必须加以解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/cee59f793740/AMS-15-78-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/664cfdfd4ce3/AMS-15-78-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/cee59f793740/AMS-15-78-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/664cfdfd4ce3/AMS-15-78-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/5702334096a1/AMS-15-78-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1cd6/12321183/6bb7023952fe/AMS-15-78-g003.jpg
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