title: A novel dental implant guided surgery based on integration of surgical template and augmented reality.
abstract: BACKGROUND
  Stereoscopic visualization concept combined with head-mounted displays may increase the accuracy of computer-aided implant surgery.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  Deviation of implant placement from planned position was significantly reduced by integrating surgical template and augmented reality technology.
authors.affiliation: Department of Mechanical Engineering, National Chung Cheng University, Chia-yi, Taiwan.
authors.forename: Yen-Kun
authors.initials: YK
authors.lastname: Lin
authors.affiliation: Department of Mechanical Engineering, National Chung Cheng University, Chia-yi, Taiwan.
authors.forename: Hong-Tzong
authors.initials: HT
authors.lastname: Yau
authors.affiliation: Graduate Periodontics, Department of Periodontics, University of Washington School of Dentistry, Seattle, WA, USA.
authors.forename: I-Chung
authors.initials: IC
authors.lastname: Wang
authors.affiliation: Department of Biostatistics, University of Washington, Seattle, WA, USA.
authors.forename: Cheng
authors.initials: C
authors.lastname: Zheng
authors.affiliation: Department of Restorative Dentistry, University of Washington School of Dentistry, Seattle, WA, USA.
authors.forename: Kwok-Hung
authors.initials: KH
authors.lastname: Chung
mesh_terms: D002983:Clinical Competence; D017076:Computer-Aided Design; D003758:Dental Implantation, Endosseous / Q000379:methods*; D015921:Dental Implants; D006801:Humans; D066298:In Vitro Techniques; D003765:Models, Dental; D009066:Mouth, Edentulous / Q000601:surgery; D010027:Osteotomy; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014584:User-Computer Interface
chemical_list: D015921:Dental Implants
keywords: accuracy; augmented reality; dental implants; guided implant surgery; surgical template