A Novel Dental Implant Guided Surgery Based on Integration of Surgical Template and Augmented Reality

Abstract

Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery. The aim of this study was to develop an augmented reality-based dental implant placement system and evaluate the accuracy of the virtually planned versus the actual prepared implant site created in vitro. Four fully edentulous mandibular and four partially edentulous maxillary duplicated casts were used. Six implants were planned in the mandibular and four in the maxillary casts. A total of 40 osteotomy sites were prepared in the casts using stereolithographic template integrated with augmented reality-based surgical simulation. During the surgery, the dentist could be guided accurately through a head-mounted display by superimposing the virtual auxiliary line and the drill stop. The deviation between planned and prepared positions of the implants was measured via postoperative computer tomography generated scan images. Mean and standard deviation of the discrepancy between planned and prepared sites at the entry point, apex, angle, depth, and lateral locations were 0.50 ± 0.33 mm, 0.96 ± 0.36 mm, 2.70 ± 1.55°, 0.33 ± 0.27 mm, and 0.86 ± 0.34 mm, respectively, for the fully edentulous mandible, and 0.46 ± 0.20 mm, 1.23 ± 0.42 mm, 3.33 ± 1.42°, 0.48 ± 0.37 mm, and 1.1 ± 0.39 mm, respectively, for the partially edentulous maxilla. There was a statistically significant difference in the apical deviation between maxilla and mandible in this surgical simulation (p < .05). Deviation of implant placement from planned position was significantly reduced by integrating surgical template and augmented reality technology.