An optimized video system for augmented reality in endodontics: a feasibility study

Taxonomic discordance of immersive realities in dentistry: A systematic scoping review.: Taxonomic discordance of immersive realities

OBJECTIVES

This review aimed to map taxonomy frameworks, descriptions, and applications of immersive technologies in the dental literature.

DATA

The Preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines was followed, and the protocol was registered at open science framework platform (https://doi.org/10.17605/OSF.IO/H6N8M).

SOURCES

Systematic search was conducted in MEDLINE (via PubMed), Scopus, and Cochrane Library databases, and complemented by manual search.

STUDY SELECTION

A total of 84 articles were included, with 81% between 2019 and 2023. Most studies were experimental (62%), including education (25%), protocol feasibility (20%), in vitro (11%), and cadaver (6%). Other study types included clinical report/technique article (24%), clinical study (9%), technical note/tip to reader (4%), and randomized controlled trial (1%). Three-quarters of the included studies were published in oral and maxillofacial surgery (38%), dental education (26%), and implant (12%) disciplines. Methods of display included head mounted display device (HMD) (55%), see through screen (32%), 2D screen display (11%), and projector display (2%). Descriptions of immersive realities were fragmented and inconsistent with lack of clear taxonomy framework for the umbrella and the subset terms including virtual reality (VR), augmented reality (AR), mixed reality (MR), augmented virtuality (AV), extended reality, and X reality.

CONCLUSIONS

Immersive reality applications in dentistry are gaining popularity with a notable surge in the number of publications in the last 5 years. Ambiguities are apparent in the descriptions of immersive realities. A taxonomy framework based on method of display (full or partial) and reality class (VR, AR, or MR) is proposed.

CLINICAL SIGNIFICANCE

Understanding different reality classes can be perplexing due to their blurred boundaries and conceptual overlapping. Immersive technologies offer novel educational and clinical applications. This domain is fast developing. With the current fragmented and inconsistent terminologies, a comprehensive taxonomy framework is necessary.

Visuo-Haptic VR and AR Guidance for Dental Nerve Block Education

The inferior alveolar nerve block (IANB) is a dental anesthetic injection that is critical to the performance of many dental procedures. Dental students typically learn to administer an IANB through videos and practice on silicone molds and, in many dental schools, on other students. This causes significant stress for both the students and their early patients. To reduce discomfort and improve clinical outcomes, we created an anatomically informed virtual reality headset-based educational system for the IANB. It combines a layered 3D anatomical model, dynamic visual guidance for syringe position and orientation, and active force feedback to emulate syringe interaction with tissue. A companion mobile augmented reality application allows students to step through a visualization of the procedure on a phone or tablet. We conducted a user study to determine the advantages of preclinical training with our IANB simulator. We found that in comparison to dental students who were exposed only to traditional supplementary study materials, dental students who used our IANB simulator were more confident administering their first clinical injections, had less need for syringe readjustments, and had greater success in numbing patients.

Evaluating augmented reality e-typodont to improve a patient's dental implant health literacy

STATEMENT OF PROBLEM

Information regarding dental implants can be difficult to understand for participants. Improving patients' dental implant health literacy remains a challenging process.

PURPOSE

The purpose of this clinical study was to develop and evaluate patients' understanding of the implant treatment procedure, components, and sequences using traditional typodont and augmented reality (AR) applications (e-typodont), with the goal of improving their oral health literacy.

MATERIAL AND METHODS

Participants who had sought dental implant treatment at the group practice and implant clinic at the University of Illinois Chicago (UIC) College of Dentistry were invited to enroll in this study. Participants were asked to fill out the first questionnaire (Q1) assessing their understanding of implant treatment procedures, components, and sequences. The participants were randomly exposed to 1 of the 2 modes of delivering education, typodont or AR e-typodont. The participants were asked to complete the additional 2 questionnaires (Q2 and Q3), and the posttest questionnaire (Q1) to re-evaluate their understanding of the implant treatment procedure, components, and sequences. All data were entered and coded into a spreadsheet. Descriptive (mean) and statistical (Wilcoxon Signed Ranks and Mann-Whitney U test) analyses were used (α=.05).

RESULTS

Both interventions significantly increased participants' understanding of implant treatments (typodont: P=.004; e-typodont: P<.001), implant components (typodont: P=.003; e-typodont: P<.001), and implant treatment sequences (typodont: P=.001; e-typodont: P<.001). The e-typodont group significantly improved participants' understanding of implant treatments (P=.006), implant components (P=.023), and implant treatment sequences (P=.008) compared with the typodont group. Participants perceived the e-typodont mode of delivery to be significantly more interesting (P=.002), interactive (P=.008), educational (P=.002), user-friendly (P=.016), and "Wow" (P=.002) compared with the traditional typodont mode of delivery.

CONCLUSIONS

Both interventions improved participants' understanding of implant treatment procedures, components, and sequences. The e-typodont showed better improvement in participants' understanding of dental implants compared with the traditional typodont.

Novel method for augmented reality guided endodontics: an in vitro study

OBJECTIVE

The aim of this study is to evaluate the accuracy in endodontics of a novel augmented reality (AR) method for guided access cavity preparation in 3D-printed jaws.

METHODS

Two operators with different levels of experience in endodontics performed pre-planned virtually guided access cavities through a novel markerless AR system developed by a team among the authors on three sets of 3D-printed jaw models using a 3D printer (Objet Connex 350, Stratasys) mounted on a phantom. After the treatment, a post-operative high-resolution CBCT scan (NewTom VGI Evo, Cefla) was taken for each model and registered to the pre-operative model. All the access cavities were then digitally reconstructed by filling the cavity area using 3D medical software (3-Matic 15.0, Materialise). For the anterior teeth and the premolars, the deviation at the coronal and apical entry points as well as the angular deviation of the access cavity were compared to the virtual plan. For the molars, the deviation at the coronal entry point was compared to the virtual plan. Additionally, the surface area of all access cavities at the entry point was measured and compared to the virtual plan. Descriptive statistics for each parameter were performed. A 95% confidence interval was calculated.

RESULTS

A total of 90 access cavities were drilled up to a depth of 4 mm inside the tooth. The mean deviation in the frontal teeth and in the premolars at the entry point was 0.51 mm and 0.77 mm at the apical point, with a mean angular deviation of 8.5° and a mean surface overlap of 57%. The mean deviation for the molars at the entry point was 0.63 mm, with a mean surface overlap of 82%.

CONCLUSION

The use of AR as a digital guide for endodontic access cavity drilling on different teeth showed promising results and might have potential for clinical use. However, further development and research might be needed before in vivo validation to overcome the limitations of the study.

Clinical Application of Augmented Reality in Computerized Skull Base Surgery

Cranial base tactics comprise the regulation of tiny and complicated structures in the domains of otology, rhinology, neurosurgery, and maxillofacial medical procedure. Basic nerves and veins are in the nearness of these buildings. Increased the truth is a coming innovation that may reform the cerebral basis approach by supplying vital physical and navigational facts brought together in a solitary presentation. In any case, the awareness and acknowledgment of prospective results of expanding reality frameworks in the cerebral base region are really poor. This article targets examining the handiness of expanded reality frameworks in cranial foundation medical procedures and emphasizes the obstacles that present innovation encounters and their prospective adjustments. A specialized perspective on distinct strategies used being produced of an improved realty framework is furthermore offered. The newest item offers an expansion in interest in expanded reality frameworks that may motivate more secure and practical procedures. In any case, a couple of concerns have to be cared to before that can be for the vast part fused into normal practice.

Augmented Reality and Virtual Reality in Dentistry: Highlights from the Current Research

Many modern advancements have taken place in dentistry that have exponentially impacted the progress and practice of dentistry. Augmented reality (AR) and virtual reality (VR) are becoming the trend in the practice of modern dentistry because of their impact on changing the patient’s experience. The use of AR and VR has been beneficial in different fields of science, but their use in dentistry is yet to be thoroughly explored, and conventional ways of dentistry are still practiced at large. Over the past few years, dental treatment has been significantly reshaped by technological advancements. In dentistry, the use of AR and VR systems has not become widespread, but their different uses should be explored. Therefore, the aim of this review was to provide an update on the contemporary knowledge, to report on the ongoing progress of AR and VR in various fields of dental medicine and education, and to identify the further research required to achieve their translation into clinical practice. A literature search was performed in PubMed, Scopus, Web of Science, and Google Scholar for articles in peer-reviewed English-language journals published in the last 10 years up to 31 March 2021, with the help of specific keywords related to AR and VR in various dental fields. Of the total of 101 articles found in the literature search, 68 abstracts were considered suitable and further evaluated, and consequently, 33 full-texts were identified. Finally, a total of 13 full-texts were excluded from further analysis, resulting in 20 articles for final inclusion. The overall number of studies included in this review was low; thus, at this point in time, scientifically-proven recommendations could not be stated. AR and VR have been found to be beneficial tools for clinical practice and for enhancing the learning experiences of students during their pre-clinical education and training sessions. Clinicians can use VR technology to show their patients the expected outcomes before the undergo dental procedures. Additionally, AR and VR can be implemented to overcome dental phobia, which is commonly experienced by pediatric patients. Future studies should focus on forming technological standards with high-quality data and developing scientifically-proven AR/VR gadgets for dental practice.

Augmented reality in craniomaxillofacial surgery: added value and proposed recommendations through a systematic review of the literature

This systematic review provides an overview of augmented reality (AR) and its benefits in craniomaxillofacial surgery in an attempt to answer the question: Is AR beneficial for craniomaxillofacial surgery? This review includes a description of the studies conducted, the systems used and their technical characteristics. The search was performed in four databases: PubMed, Cochrane Library, Embase, and Web of Science. All journal articles published during the past 11 years related to AR, mixed reality, craniomaxillofacial, and surgery were considered in this study. From a total of 7067 articles identified using AR- and surgery-related keywords, 39 articles were finally selected. Based on these articles, a classification of study types, surgery types, devices used, metrics reported, and benefits were collected. The findings of this review indicate that AR could provide various benefits, addressing the challenges of conventional navigation systems, such as hand-eye coordination and depth perception. However, three main concerns were raised while performing this study: (1) it is complicated to aggregate the metrics reported in the articles, (2) it is difficult to obtain statistical value from the current studies, and (3) user evaluation studies are lacking. This article concludes with recommendations for future studies by addressing the latter points.

Clinical applications of intraoral camera to increase patient compliance - current perspectives

Technological advancements in the field of dentistry have reformed the concept of photography as a powerful medium of expression and communication. It also offers a spectrum of perception, interpretation, and execution. One of the widespread clinical applications of computerization in dentistry today is the intraoral camera (IOC). It helps in the revelation of the hidden and overlooked defects in teeth and other parts of the cavity. Dental world constitutes of microstructures that have to be recorded in a detailed manner to perform patient education, documentation of records and treatment, illustration of lectures, publication and web connectivity of complicated cases. This review emphasizes the significant applications of IOC in dentistry and its possible impact on patient compliance for dental care.

Current state of the art in the use of augmented reality in dentistry: a systematic review of the literature

Background

The aim of the present systematic review was to screen the literature and to describe current applications of augmented reality.

Materials and methods

The protocol design was structured according to PRISMA-P guidelines and registered in PROSPERO. A review of the following databases was carried out: Medline, Ovid, Embase, Cochrane Library, Google Scholar and the Gray literature. Data was extracted, summarized and collected for qualitative analysis and evaluated for individual risk of bias (R.O.B.) assessment, by two independent examiners. Collected data included: year of publishing, journal with reviewing system and impact factor, study design, sample size, target of the study, hardware(s) and software(s) used or custom developed, primary outcomes, field of interest and quantification of the displacement error and timing measurements, when available. Qualitative evidence synthesis refers to SPIDER.

Results

From a primary research of 17,652 articles, 33 were considered in the review for qualitative synthesis. 16 among selected articles were eligible for quantitative synthesis of heterogenous data, 12 out of 13 judged the precision at least as acceptable, while 3 out of 6 described an increase in operation timing of about 1 h. 60% (n = 20) of selected studies refers to a camera-display augmented reality system while 21% (n = 7) refers to a head-mounted system. The software proposed in the articles were self-developed by 7 authors while the majority proposed commercially available ones. The applications proposed for augmented reality are: Oral and maxillo-facial surgery (OMS) in 21 studies, restorative dentistry in 5 studies, educational purposes in 4 studies and orthodontics in 1 study. The majority of the studies were carried on phantoms (51%) and those on patients were 11 (33%).

Conclusions

On the base of literature the current development is still insufficient for full validation process, however independent sources of customized software for augmented reality seems promising to help routinely procedures, complicate or specific interventions, education and learning. Oral and maxillofacial area is predominant, the results in precision are promising, while timing is still very controversial since some authors describe longer preparation time when using augmented reality up to 60 min while others describe a reduced operating time of 50/100%.

Trial registration

The following systematic review was registered in PROSPERO with RN: CRD42019120058.

A novel noise filtered and occlusion removal: navigational accuracy in augmented reality-based constructive jaw surgery

PURPOSE

Augmented reality-based constructive jaw surgery has been facing various limitations such as noise in real-time images, the navigational error of implants and jaw, image overlay error, and occlusion handling which have limited the implementation of augmented reality (AR) in corrective jaw surgery. This research aimed to improve the navigational accuracy, through noise and occlusion removal, during positioning of an implant in relation to the jaw bone to be cut or drilled.

METHOD

The proposed system consists of a weighting-based de-noising filter and depth mapping-based occlusion removal for removing any occluded object such as surgical tools, the surgeon's body parts, and blood.

RESULTS

The maxillary (upper jaw) and mandibular (lower jaw) jaw bone sample results show that the proposed method can achieve the image overlay error (video accuracy) of 0.23~0.35 mm and processing time of 8-12 frames per second compared to 0.35~0.45 mm and 6-11 frames per second by the existing best system.

CONCLUSION

The proposed system concentrates on removing the noise from the real-time video frame and the occlusion. Thus, the acceptable range of accuracy and the processing time are provided by this study for surgeons for carrying out a smooth surgical flow.

Augmented reality in dentistry: a current perspective

Augmentation reality technology offers virtual information in addition to that of the real environment and thus opens new possibilities in various fields. The medical applications of augmentation reality are generally concentrated on surgery types, including neurosurgery, laparoscopic surgery and plastic surgery. Augmentation reality technology is also widely used in medical education and training. In dentistry, oral and maxillofacial surgery is the primary area of use, where dental implant placement and orthognathic surgery are the most frequent applications. Recent technological advancements are enabling new applications of restorative dentistry, orthodontics and endodontics. This review briefly summarizes the history, definitions, features, and components of augmented reality technology and discusses its applications and future perspectives in dentistry.

Implementation of augmented reality in operative dentistry learning

OBJECTIVE

To evaluate the efficacy of augmented reality (AR) in the gaining of knowledge and skills amongst dental students in the design of cavity preparations and analyse their degree of satisfaction.

MATERIAL AND METHODS

AR cavity models were prepared for use with computers and mobile devices. Forty-one students were divided into two groups (traditional teaching methods vs AR). Questionnaires were designed to evaluate knowledge and skills, with the administration of a satisfaction questionnaire for those using AR. The degree of compliance with the standards in cavity design was assessed. The Mann-Whitney U-test was used to compare knowledge and skills between the two groups, and the Wilcoxon test was applied to compare intragroup differences. The chi-square test in turn was used to compare the qualitative parameters of the cavity designs between the groups. Statistical significance was considered for P<.05 in all cases.

RESULTS

No significant differences were observed in level of knowledge before, immediately after or 6 months after teaching between the two groups (P>.05). Although the results corresponding to most of the studied skills parameters were better in the experimental group, significant differences (P<.05) were only founded for cavity depth and extent for Class I and divergence of the buccal and lingual walls for the Class II. The experience was rated as favourable or very favourable by 100% of the participants. The students showed preference for computers (60%) vs mobile devices (10%).

CONCLUSIONS

The AR techniques favoured the gaining of knowledge and skills and were regarded as a useful tool by the students.

Robot-Assisted Surgery for Mandibular Angle Split Osteotomy Using Augmented Reality: Preliminary Results on Clinical Animal Experiment

Mandibular angle split osteotomy (MASO) is a procedure widely used for prominent mandibular angles. However, conventional mandibular plastic surgery is invasive and high risk. It may induce postoperative neurosensory disturbance of the inferior alveolar nerve, fractures and infection due to the complexity of the anatomical structure and the narrow surgical field of view. The success rate of MASO surgery usually depends on the clinical experience and skills of the surgeon. To evaluate the performance of inexperienced plastic surgeons conducting this surgery, a self-developed and constructed robot system based on augmented reality is used. This robot system provides for sufficient accuracy and safety within the clinical environment. To evaluate the accuracy and safety of MASO surgery, an animal study using this robot was performed in the clinical room, and the results were then evaluated. Four osteotomy planes were successfully performed on two dogs; that is, twenty tunnels (each dog drilled on bilaterally) were drilled in the dogs' mandible bones. Errors at entrance and target points were 1.04 ± 0.19 and 1.22 ± 0.24 mm, respectively. The angular error between the planned and drilled tunnels was 6.69° ± 1.05°. None of the dogs experienced severe complications. Therefore, this technique can be regarded as a useful approach for training inexperienced plastic surgeons on the various aspects of plastic surgery.

NO LEVEL ASSIGNED

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A study of an assisting robot for mandible plastic surgery based on augmented reality

BACKGROUND

Mandible plastic surgery plays an important role in conventional plastic surgery. However, its success depends on the experience of the surgeons. In order to improve the effectiveness of the surgery and release the burden of surgeons, a mandible plastic surgery assisting robot, based on an augmented reality technique, was developed.

MATERIAL AND METHODS

Augmented reality assists surgeons to realize positioning. Fuzzy control theory was used for the control of the motor. During the process of bone drilling, both the drill bit position and the force were measured by a force sensor which was used to estimate the position of the drilling procedure.

RESULTS

An animal experiment was performed to verify the effectiveness of the robotic system. The position error was 1.07 ± 0.27 mm and the angle error was 5.59 ± 3.15°. The results show that the system provides a sufficient accuracy with which a precise drilling procedure can be performed. In addition, under the supervision's feedback of the sensor, an adequate safety level can be achieved for the robotic system.

CONCLUSION

The system realizes accurate positioning and automatic drilling to solve the problems encountered in the drilling procedure, providing a method for future plastic surgery.

Augmented reality in healthcare education: an integrative review

Background. The effective development of healthcare competencies poses great educational challenges. A possible approach to provide learning opportunities is the use of augmented reality (AR) where virtual learning experiences can be embedded in a real physical context. The aim of this study was to provide a comprehensive overview of the current state of the art in terms of user acceptance, the AR applications developed and the effect of AR on the development of competencies in healthcare.

Methods. We conducted an integrative review. Integrative reviews are the broadest type of research review methods allowing for the inclusion of various research designs to more fully understand a phenomenon of concern. Our review included multi-disciplinary research publications in English reported until 2012.

Results. 2529 research papers were found from ERIC, CINAHL, Medline, PubMed, Web of Science and Springer-link. Three qualitative, 20 quantitative and 2 mixed studies were included. Using a thematic analysis, we’ve described three aspects related to the research, technology and education. This study showed that AR was applied in a wide range of topics in healthcare education. Furthermore acceptance for AR as a learning technology was reported among the learners and its potential for improving different types of competencies.

Discussion. AR is still considered as a novelty in the literature. Most of the studies reported early prototypes. Also the designed AR applications lacked an explicit pedagogical theoretical framework. Finally the learning strategies adopted were of the traditional style ‘see one, do one and teach one’ and do not integrate clinical competencies to ensure patients’ safety.