title: [Virtual simulation of dental surgery using a three-dimensional computer model with a force feedback system].
abstract: BACKGROUND
  Selective reduction of bone without injuring inner structures is an essential part of surgical techniques, especially during dental surgery. Virtual drilling is possible using a new simulator. The following illustrates simulation of an apicectomy.
  
  
  METHODS
  Using the VOXEL-MAN system, a virtual three-dimensional model of a skull was created based on CT data. Both inferior alveolar nerves and apical inflammations of teeth 23, 25, 36, and 35 were virtually simulated. To achieve a realistic drilling effect with the force feedback system, special tools were integrated into VOXEL-MAN to obtain a high resolution of collision recognition. Adding drilling noises further improved the simulation. Spatial 3D perception was possible with the help of shutter glasses.
  
  
  RESULTS
  The presented computer model enabled the visual and haptic observation of complex volume-based models and virtual interaction with them. The haptic feeling proved to be convincing because of collision recognition, consideration of drilling parameters, and addition of drilling noises. Via postoperative reconstructions, polydimensional verification of performed drilling routes is possible.
  
  
  CONCLUSIONS
  Using apicectomies as examples, realistic simulation of dental surgical procedures, even in complex anatomical models, is possible. Generally, it is possible to add virtual pathologies in data sets and/or to use anonymous patient data sets to extend the range of simulated surgical procedures.
authors.affiliation: Kopf- und Hautzentrum, Klinik und Poliklinik für Zahn-, Mund-, Kiefer- und Gesichtschirurgie, Universitätsklinikum Hamburg-Eppendorf. heiland@uke.uni-hamburg.de
authors.forename: M
authors.initials: M
authors.lastname: Heiland
authors.forename: N
authors.initials: N
authors.lastname: Von Sternberg-Gospos
authors.forename: B
authors.initials: B
authors.lastname: Pflesser
authors.forename: D
authors.initials: D
authors.lastname: Schulze
authors.forename: K H
authors.initials: KH
authors.lastname: Höhne
authors.forename: R
authors.initials: R
authors.lastname: Schmelzle
authors.forename: A
authors.initials: A
authors.lastname: Petersik
mesh_terms: D001047:Apicoectomy; D003198:Computer Simulation; D005246:Feedback; D006801:Humans; D021621:Imaging, Three-Dimensional; D012985:Software Design; D013515:Surgery, Oral / Q000193:education*; D036542:Tomography, Spiral Computed; D014584:User-Computer Interface