Current and future use of virtual and augmented reality in minimal invasive oral surgery

In the last years there has been a change from the concept of traditionally oral surgery into minimal invasive surgery.Thus, a large number of practitioners started using magnification devices in their practice.These devices enhance visibility of the working field and permit to limit the size and number of cuts, or incisions.The most common are loupes, but they have limitations such as convergent vision, deficient magnification, image distortion, or small depth of focus.These limitations were superseded by the use of surgical microscope (SM) that allows amplification of detail and excellent visualisation of the working field.The SM is very important in the development of minimally invasive oral surgery, but today, the computer and new software play a key role.The main tissue types, organs and lesions can be identified, using medical imaging techniques, such as computed tomography (CT) or magnetic resonance imaging (MRI).Although these images contain all required information about patients and their organs, it may be difficult to perceive the extent of a lesion and its relationship with the surrounding tissues.Thus, the role of software for 3-dimensional (3D) visualization is very important.These software permit to visualize 3D images from a set of 2-dimensional (2D) images, using direct volume rendering technique; therefore, all acquired data can be composed to a digital 3D virtual model of the patient's mouth.According to its definition "Virtual reality (VR) refers to computergenerated environments or realities that are designed to simulate a person's physical presence in a specific environment that is designed to feel real".Using VR, an oral surgeon can visualize the lesions, to study a treatment plan, and can identify possible complications at the same time.Vision and tactile sense are the principal sensory inputs employed by humans in object manipulation tasks.Using VR and haptic technology, an oral surgeon will be able to simulate a virtual surgical treatment.The word "haptics" comes from the greek words haptikos (meaning able to come into contact with) and haptesthai (meaning touch or contact) 1 .Haptic technology, also known as kinaesthetic communication or 3D touch, is currently used in robot-assisted minimally invasive surgery [1].The haptic interface is a device that allows a virtual or remote environment to stimulate the sense of touch on a human operator.Today, a number of haptic interfaces with different structures have been developed and are commercially available.These devices have been widely used in a multitude of applications such as graphical user interfaces, games, education and training etc.Using VR and haptic interfaces it will be possible create virtual patients and will be possible, also, to carry out a virtual oral surgical procedure.In surgical simulation, realistic interactions between surgeon, objects and virtual patient are very important, thus the end-effector of interfaces for surgical use, covers the natural range of motion of the human hand.Currently, these simulators are an important part of training of students and surgeons [2], but in