Augmented Reality and 3-Dimensional Dynamic Navigation System Integration for Osteotomy and Root-end Resection

Frederico C Martinho; Ina L Griffin; Jeffery B Price; Patricia A Tordik

doi:10.1016/j.joen.2023.07.007

Augmented Reality and 3-Dimensional Dynamic Navigation System Integration for Osteotomy and Root-end Resection

J Endod. 2023 Oct;49(10):1362-1368. doi: 10.1016/j.joen.2023.07.007. Epub 2023 Jul 13.

Authors

Frederico C Martinho¹, Ina L Griffin², Jeffery B Price³, Patricia A Tordik²

Affiliations

¹ Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland. Electronic address: fmartinho@umaryland.edu.
² Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
³ Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland.

PMID: 37453501
DOI: 10.1016/j.joen.2023.07.007

Abstract

Introduction: Augmented reality (AR) superimposes high-definition computer-generated virtual content onto the existing environment, providing users with an enhanced perception of reality. This study investigates the feasibility of integrating an AR head-mounted device into a 3-dimensional dynamic navigation system (3D-DNS) for osteotomy and root-end resection (RER). It compares the accuracy and efficiency of AR + 3D-DNS to 3D-DNS for osteotomy and RER.

Methods: Seventy-two tooth roots of 3D-printed surgical jaw models were divided into two groups: AR + 3D-DNS (n = 36) and 3D-DNS (n = 36). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were virtually planned on X-guide software and delivered under 3D-DNS guidance. For the AR + 3D-DNS group, an AR head-mounted device (Microsoft HoloLens 2) was integrated into the 3D-DNS. The 2D- and 3D-deviations were calculated. The osteotomy and RER time and the number of procedural mishaps were recorded.

Results: Osteotomy and RER were completed in all samples (72/72). AR + 3D-DNS was more accurate than 3D-DNS, showing lower 2D- and 3D-deviation values (P < .05). The AR + 3D-DNS was more efficient in time than 3D-DNS (P < .05). There was no significant difference in the number of mishaps (P > .05).

Conclusions: Within the limitations of this in vitro study, the integration of an AR head-mounted device to 3D-DNS is feasible for osteotomy and RER. AR improved the accuracy and time efficiency of 3D-DNS in osteotomy and RER. Head-mounted AR has the potential to be safely and reliably integrated into 3D-DNS for endodontic microsurgery.

Keywords: AR; Augmented reality; dynamic navigation; endodontic microsurgery.