Augmented Reality in Oral Surgery
Condition: Impacted Tooth
MeSH terms: Tooth, Impacted
Study type: Observational

Summary: 
      A digital workflow was used to assist the oral surgeon in pre-orthodontic exposure of a
      vestibular impacted canine using Augmented Reality.

      Through software for the Object Recognition and Tracking, the researchers expand reality with
      cone beam computer tomography digital contents to optimize the outcome of surgery. The
      real-time video frames of the operating field aligned with the three-dimension file of the
      impacted tooth, were used as a guide to evaluate the surgical access to perform a minimally
      invasive flap and osteotomy.
    

Detailed description: 
      This study evaluate an AR-assisted approach for surgical exposure of a maxillary impacted
      canine. The usual protocol is the following:

        -  Maxillary arches were scanned, and their occlusal relationship was registered using an
           optical intraoral scanner.The file was exported in Polygon File Format (PLY)

        -  Using open-source CAD software, the part of the upper arch was selected from the first
           premolar to the other first premolars The teeth, the incisal edges and the cusps of the
           anterior sector were the anatomical markers required to match the patient's mouth and
           perform the object recognition.To this file that corresponded faithfully to reality we
           added the digital information required, that is, the position of the impacted crown of
           the canine

        -  From the maxillary CBCT, DICOM files were imported in open-source medical software for
           segmentation and exportation of an STL file of the area of interest

        -  Two 3D files obtained were imported into a CAD-CAM design software for superimposition.
           3D file consisting of the intraoral scan plus the endosseous position of the crown of
           the impacted canine was exported

        -  A full HD video camera was positioned in front of the patient's mouth, connected via an
           HDMI cable to a laptop

        -  The AR software was then started, and the video camera was associated as an input source
           The software recognizes edges of files in images transmitted from the camera and overlap
           the object to the video images.
    

Intervention name(s): Surgical exposure of impacted tooth
Intervention type(s): Procedure
Intervention description(s): The therapeutic approach of surgical exposure of impacted teeth is performed by preparing a flap and removing the cortical bone around the crown of the teeth.
This procedure provides optimal conditions for the orthodontist. In fact, surgical exposure allows the orthodontist to bond the impacted tooth in the correct position depending on the intended direction to apply the correct traction forces for alignment.
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Patients with impactet tooth. In growing age or not.
      
Keywords: Augmented reality; Oral Surgery; Computer guided surgery; Computer assisted surgery