Sander Tabernée Heijtmeijer, Haye Glas, Nard Janssen, Nathalie Vosselman, Sebastiaan de Visscher, Fred Spijkervet, Gerry Raghoebar, Remco de Bree, Antoine Rosenberg, Max Witjes, Joep Kraeima
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引用次数: 0
摘要
目的:由于颧骨骨量有限、能见度有限、钻孔路径长以及靠近关键解剖结构,将颧骨植入物放置在最佳修复位置具有挑战性。增强现实(AR)导航可以消除手术导板和传统手术导航的一些缺点,同时还有可能提高准确性。在这项人体尸体研究中,我们评估了在全上颌骨切除术后植入颧骨种植体的AR导航方法:开发的 AR 导航界面将商业导航系统与 Microsoft HoloLens 连接起来。在全上颌骨切除术后,使用五个人体尸体头骨进行了AR导航手术,植入了20颗颧骨植入体。为确定准确性,术后扫描与术前三维虚拟手术规划进行了虚拟匹配,并计算了以毫米为单位的出入口点距离和角度偏差作为结果测量。结果与之前进行的一项研究进行了比较,在这项研究中,颧骨植入物是用三维打印的手术导板定位的:平均入口点偏差为 2.43 ± 1.33 毫米,三维角度偏差为 5.80 ± 4.12°(范围为 1.39-19.16°)。出口点平均偏差为 3.28 毫米(±2.17)。基台高度偏差平均为 2.20 ± 1.35 毫米。基台在咬合面上的精确度为 4.13 ± 2.53 mm。手术导板在入口点(P = 0.012)和三维角度(P = 0.05)方面的表现明显更好;然而,在使用 3D 打印钻导或 AR 导航手术时,出口点的精确度没有明显差异(P = 0.143):结论:尽管手术导板的精度更高,但 AR 导航表现出了可接受的准确性,具有改进和专业应用的潜力。该研究强调了 AR 导航在颧骨种植体植入中的可行性,为传统方法提供了一种替代方案。
Accuracy of augmented reality navigated surgery for placement of zygomatic implants: a human cadaver study.
Purpose: Placement of zygomatic implants in the most optimal prosthetic position is considered challenging due to limited bone mass of the zygoma, limited visibility, length of the drilling path and proximity to critical anatomical structures. Augmented reality (AR) navigation can eliminate some of the disadvantages of surgical guides and conventional surgical navigation, while potentially improving accuracy. In this human cadaver study, we evaluated a developed AR navigation approach for placement of zygomatic implants after total maxillectomy.
Methods: The developed AR navigation interface connects a commercial navigation system with the Microsoft HoloLens. AR navigated surgery was performed to place 20 zygomatic implants using five human cadaver skulls after total maxillectomy. To determine accuracy, postoperative scans were virtually matched with preoperative three-dimensional virtual surgical planning, and distances in mm from entry-exit points and angular deviations were calculated as outcome measures. Results were compared with a previously conducted study in which zygomatic implants were positioned with 3D printed surgical guides.
Results: The mean entry point deviation was 2.43 ± 1.33 mm and a 3D angle deviation of 5.80 ± 4.12° (range 1.39-19.16°). The mean exit point deviation was 3.28 mm (±2.17). The abutment height deviation was on average 2.20 ± 1.35 mm. The accuracy of the abutment in the occlusal plane was 4.13 ± 2.53 mm. Surgical guides perform significantly better for the entry-point (P = 0.012) and 3D angle (P = 0.05); however, there is no significant difference in accuracy for the exit-point (P = 0.143) when using 3D printed drill guides or AR navigated surgery.
Conclusion: Despite the higher precision of surgical guides, AR navigation demonstrated acceptable accuracy, with potential for improvement and specialized applications. The study highlights the feasibility of AR navigation for zygomatic implant placement, offering an alternative to conventional methods.
期刊介绍:
PeerJ is an open access peer-reviewed scientific journal covering research in the biological and medical sciences. At PeerJ, authors take out a lifetime publication plan (for as little as $99) which allows them to publish articles in the journal for free, forever. PeerJ has 5 Nobel Prize Winners on the Board; they have won several industry and media awards; and they are widely recognized as being one of the most interesting recent developments in academic publishing.