Name: dynamic navigation for dental implant placement
Uploaded: 2022-09-13T12:40:00
Description: Watch this Scientific Journal Video about Dynamic Navigation for Dental Implant Placement at JoVE.com

这项研究没有从公共、商业或非营利部门的资助机构获得任何具体资助。

手术前获得每位患者的知情同意。干预后，本研究使用匿名回顾性数据。
1. 使用标记夹校准方法的动态导航系统传统工作流程中的步骤（仅适用于带齿的颚骨）：
<ol><li>将不透射线的固定夹连接到要使用热塑性材料进行治疗的颌骨牙齿（上颌骨/下颌骨）上。</li>
	<li>用口腔中的标记夹子对患者进行CBCT检查（CBCT，FOV 8 cm x 11 cm，12 mA，95 kV）。</li>
	<li>使用适当的?...

<ol>
	<li>Block, M. S., Emery, R. W., Cullum, D. R., Sheikh, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implant+placement+is+more+accurate+using+dynamic+navigation.">Implant placement is more accurate using dynamic navigation.</a> Journal of Oral and Maxillofacial Surgery. 75 (7), 1377-1386 (2017).</li><li>Kaewsiri, D., Panmekiate, S., Subbalekha, K., Mattheos, N., Pimkhaokham, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+accuracy+of+static+vs.+dynamic+computer-assisted+implant+surgery+in+single+tooth+space:+A+randomized+controlled+trial.">The accuracy of static vs. dynamic computer-assisted implant surgery in single tooth space: A randomized controlled trial.</a> Clinical Oral Implants Research. 30 (6), 505-514 (2019).</li><li>Block, M. S., Emery, R. W. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Static+or+dynamic+navigation+for+implant+placement-choosing+the+method+of+guidance.">Static or dynamic navigation for implant placement-choosing the method of guidance.</a> Journal of Oral and Maxillofacial Surgery. 74 (2), 269-277 (2016).</li><li>Stefanelli, L. V., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+a+novel+trace-registration+method+for+dynamic+navigation+surgery.">Accuracy of a novel trace-registration method for dynamic navigation surgery.</a> International Journal of Periodontics &amp; Restorative Dentistry. 40 (3), 427-435 (2020).</li><li>Mediavilla Guzman, A., Riad Deglow , E., Zubizarreta-Macho, A., Agustin-Panadero, R., Hernandez Montero, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+computer-aided+dynamic+navigation+compared+to+computer-aided+static+navigation+for+dental+implant+placement:+An+in+vitro+study.">Accuracy of computer-aided dynamic navigation compared to computer-aided static navigation for dental implant placement: An in vitro study.</a> Journal of Clinical Medicine. 8 (12), 2123 (2019).</li><li>Sun, T. M., Lan, T. H., Pan, C. Y., Lee, H. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dental+implant+navigation+system+guide+the+surgery+future.">Dental implant navigation system guide the surgery future.</a> Kaohsiung Journal of Medical Sciences. 34 (1), 56-64 (2018).</li><li>Wu, Y., Wang, F., Fan, S., Chow, J. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Robotics+in+dental+implantology.">Robotics in dental implantology.</a> Oral and Maxillofacial Surgery Clinics of North America. 31 (3), 513-518 (2019).</li><li>Block, M. S., Emery, R. W., Lank, K., Ryan, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Implant+placement+accuracy+using+dynamic+navigation.">Implant placement accuracy using dynamic navigation.</a> International Journal of Oral &amp; Maxillofacial Implants. 32 (1), 92-99 (2017).</li><li>Panchal, N., Mahmood, L., Retana, A., Emery, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Dynamic+navigation+for+dental+implant+surgery.">Dynamic navigation for dental implant surgery.</a> Oral and Maxillofacial Surgery Clinics of North America. 31 (4), 539-547 (2019).</li><li>Emery, R. W., Merritt, S. A., Lank, K., Gibbs, J. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Accuracy+of+dynamic+navigation+for+dental+implant+placement-model-based+evaluation.">Accuracy of dynamic navigation for dental implant placement-model-based evaluation.</a> Journal of Oral Implantology. 42 (5), 399-405 (2016).</li></ol>

在带标签的夹子使用的动态导航植入物放置系统中，传统的工作流程是通过夹子校准完成的。夹子表面有三个不透射线的金属球，在CBCT扫描中清晰可见。在示踪剂校准方法的情况下，这些包含夹子的金属球既不需要CBCT扫描，也不是系统校准所必需的。在现有牙齿的情况下，可以使用带标签和未标记的夹子（两种不同的校准方法）。夹子用热塑性材料固定在牙齿上。在无齿情况下，只能使用没有?...

为了提高种植牙的准确性并减少并发症，已经开发了一系列基于成像研究的导航技术。术前成像和专用3D种植体规划软件可用于规划种植牙1、2的确切位置。
种植体手术导航的目的是在解剖学上更精确地放置种植牙，以达到最理想的位置，以降低可能的医源性并发症（神经、血管、骨骼和鼻窦损伤）的风险。导航手术减少了干预（无瓣手术）的侵入性，这可以减少投诉并加快恢复速度。准确的种植体放置基于先前的修复计划（可以在术前安装牙齿的基础上进行手术），并且最佳的种植体位置有助于避免骨移植。
如今，有两种类型的计算机辅助植入物（CAI）手术放置导航系统 - 静态和动态导航系统。静态导航是一种使用预先计划和预制的手术模板的受控植入物放置方法。动态导航是一种预先计划的计算机引导植入手术放置方法，无需使用光学控制的手术模板。控制程序使用基于点云的图像配准，通过应用3D图像叠加3将虚拟图像与真实环境合并。
DCAI系统使在类似GPS的框架内实现实时、客观的仪器控制成为可能。通常，它们使用光学跟踪来检测和跟踪放置在患者和手术器械上的（光学）参考标记的位置，并提供有关植入手术放置过程的连续视觉反馈1，2。
手术过程中手术器械的运动和位置可以在监视器上的三维图像上实时监控。在手术过程中，摄像系统允许连续监测和比较患者颚骨的位置和手术器械的位置。
动态导航系统有两种类型：一种是被动系统，在这种情况下，配准设备（参考基座）将从光源发出的光反射回立体摄像机;另一种是有源系统，其中注册设备发出光，然后是立体摄像机4，5。
下一级动态导航系统使用伺服电机通过触觉刺激引导外科医生的手，以便带有机械臂的设备可以确定外科医生的动作，甚至在遥远的未来完全取代它们4，5，6，7。

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>DTX Implant Studio Software</td>
			<td>Nobel Biocare</td>
			<td>106182</td>
			<td>3D surgical planing software</td>
		</tr>
		<tr>
			<td>MeshLab</td>
			<td>ISTI - CNR research center</td>
			<td>2020.12</td>
			<td>3D mesh processing software</td>
		</tr>
		<tr>
			<td>Nobel Replace CC implant</td>
			<td>Nobel Biocare</td>
			<td>37285</td>
			<td>Implant</td>
		</tr>
		<tr>
			<td>X-Guide</td>
			<td>X-Nav - Nobel Biocare</td>
			<td>SN00001310</td>
			<td>dinamic navigation surgery system</td>
		</tr>
		<tr>
			<td>X-Guide - XClip</td>
			<td>X-Nav - Nobel Biocare</td>
			<td>XNVP008381</td>
			<td>3D navigation registration device</td>
		</tr>
		<tr>
			<td>X-Guide planing software</td>
			<td>X-Nav - Nobel Biocare</td>
			<td>XNVP008296</td>
			<td>3D surgical planing and operating software</td>
		</tr>
		<tr>
			<td>X-Mark probe</td>
			<td>X-Nav - Nobel Biocare</td>
			<td>XNVP008886</td>
			<td>3D navigation registration tool</td>
		</tr>
		<tr>
			<td>PaX-i3D Smart</td>
			<td>Vatech</td>
			<td></td>
			<td>CBCT</td>
		</tr>
		<tr>
			<td>Prolene 5.0</td>
			<td></td>
			<td></td>
			<td>5.0 monofilament, nonabsorbable polypropylene suture</td>
		</tr>
	</tbody>
</table>

dynamic navigation for dental implant placement

在现代种植学中，手术导航系统的应用变得越来越重要。除了静态手术导航方法外，独立于导引的动态导航植入物放置程序也变得越来越普遍。该程序基于使用光学控制的计算机引导的种植牙放置。这项工作旨在演示新的计算机辅助种植手术（DCAIS）系统（设计，校准，手术）的技术步骤，并检查结果的准确性。基于锥形束计算机断层扫描（CBCT）扫描，使用专用软件确定植入物的确切位置。操作的第一步是导航系统的校准，可以通过两种方式执行：1）基于用标记拍摄的CBCT图像或2）基于没有标记的CBCT图像。根据术前计划在实时导航的帮助下插入植入物。干预措施的准确性可以根据术后CBCT图像进行评估。根据种植体的角度（度数）、平台和顶端偏差（mm），比较包含种植体计划位置的术前图像和术后CBCT图像。为了评估数据，我们计算了计划和执行的种植体位置内偏差的标准差（SD），平均值和平均值标准误差（SEM）。根据这些数据比较了两种校准方法之间的差异。根据迄今为止进行的干预措施，使用DCAIS可以实现高精度的种植体放置。不需要标记CBCT记录的校准系统允许手术干预，其准确性与使用标记的系统相似。通过培训可以提高干预的准确性。

要正确使用 DCAIS，必须对系统进行校准。有几种校准方法会影响植入物放置的准确性。本研究旨在评估不同校准方法对DCAIS精度的潜在影响。
根据迄今为止进行的干预措施，使用DCAIS可以实现高精度的种植体放置。在我们的早期研究中，我们比较了41个夹子校准的动态导航种植体放置和17个示踪剂校准的动态导航种植体放置。
根据我们早期的数据（表<strong...

Watch this Scientific Journal Video about Dynamic Navigation for Dental Implant Placement at JoVE.com

Dynamic Navigation for Dental Implant Placement

动态计算机辅助种植手术 （DCAIS） 是一种使用光学控制在没有手术模板的情况下进行的受控种植体手术放置方法。术中对手术装置运动和位置的实时控制简化了手术，为外科医生提供了更多的自由度，提供了与静态导航方法相似的精度。

种植牙的动态导航

In modern implantology, the application of surgical navigation systems is becoming increasingly important. In addition to static surgical navigation ...

数字计算机植入系统可在类似GPS的框架内实现实时对象化仪器控制。手术期间器械的位置可以在监视器上的三维图像上实时监控。这种技术精确，微创，不需要手术导板，并且易于在小口中使用。计划和手术可以在同一天进行，并且在手术过程中可以修改。建议在现场使用之前在牙科图像上练习该方法。该程序将由我们系的助理教授Tamas Huszar演示。首先在热塑性材料的帮助下，将无线电包固定夹连接到治疗部位的颚骨牙齿上。对患者进行锥形束计算机断层扫描或 CBCT 检查，并在口腔中贴上标记的夹子。使用适当的软件根据假体结构规划植入物的位置。通过校准插入手机的手柄卡盘和旋转标记盘来注册头件。然后将手臂组装在患者追踪器和标记的夹子之间并对其进行校准。要检查设备校准，请将将光学标记或跟踪器固定在牙齿上的标记夹子上，植入植入物将在其上放置。确保将夹子插入术前CBCT上登记的相同位置。然后用探头的枢轴触摸夹子的金属球，以校准标记的夹子。要执行导航种植体放置和局部麻醉，请测量钻头长度并检查实时视觉准确性。确定钻孔的入口点，并在没有襟翼的情况下探索作业现场。接下来，使用动态导航控件钻孔骨骼。测量植入物长度后，将植入物与佩戴动态导航系统控制的跟踪器的手机一起放置。用5/0单丝不可吸收聚丙烯缝合线闭合伤口或固定预制假肢。然后获取对照放射图像。对患者进行全血细胞CT，口腔中没有夹子。使用适当的软件根据假体结构规划植入物的位置，并如前所述校准设备。为了在没有标记夹子的情况下校准系统，请将植入物的手术放置计划传输到导航系统软件中。然后在导航软件的三维CT图像上选择工作区。用未标记的夹子将跟踪器固定在牙齿上，或者在无牙颌的情况下，固定一个特殊的跟踪器固定臂。然后在导航系统的3D CT图像上选择至少三个典型的解剖点。通过用探针工具触摸口腔中选定的解剖点来识别它们。通过用探针在解剖结构的表面上绘制，对三到四个区域执行细化程序。在局部麻醉下，将植入物与导航放置并测量钻头长度。在确定钻孔点和在没有襟翼的情况下探索操作部位之前，检查牙齿或骨头表面的实时视觉精度。使用动态导航控件钻孔骨骼。在放置植入物之前测量植入物长度，手机佩戴动态导航控制跟踪器。用5/0单丝不可吸收聚丙烯缝合伤口，或固定预制假肢。然后，开始控制放射成像。早期研究的数据显示，平台与颊舌和中远端方向的角度偏差之间没有显着相关性。当比较植入物的计划和最终位置时，与示踪剂校准方法相比，夹子校准方法证明更准确，没有显着差异。必须检查校准的连续性和程序的跟踪。系统将发出任何故障信号。该程序允许许多跟踪的牙科治疗，例如根尖截肢，正颌手术，牙髓手术或复杂的智齿拔除。

dynamic-navigation-for-dental-implant-placement

Research

JoVE Journal

Medicine

Shrinkage of Dental Composite in Simulated Cavity Measured with Digital Image Correlation

Polymerization shrinkage of dental resin composites can lead to restoration debonding or cracked tooth tissues in composite-restored teeth. In order to understand where and how shrinkage strain and stress develop in such restored teeth, Digital Image Correlation (DIC) was used to provide a comprehensive view of the displacement and strain distributions within model restorations that had undergone polymerization shrinkage.
Specimens with model cavities were made of cylindrical glass rods with both diameter and length being 10 mm. The dimensions of the mesial-occlusal-distal (MOD) cavity prepared in each specimen measured 3 mm and 2 mm in width and depth, respectively. After filling the cavity with resin composite, the surface under observation was sprayed with first a thin layer of white paint and then fine black charcoal powder to create high-contrast speckles. Pictures of that surface were then taken before curing and 5 min after. Finally, the two pictures were correlated using DIC software to calculate the displacement and strain distributions.
The resin composite shrunk vertically towards the bottom of the cavity, with the top center portion of the restoration having the largest downward displacement. At the same time, it shrunk horizontally towards its vertical midline. Shrinkage of the composite stretched the material in the vicinity of the &#8220;tooth-restoration&#8221; interface, resulting in cuspal deflections and high tensile strains around the restoration. Material close to the cavity walls or floor had direct strains mostly in the directions perpendicular to the interfaces. Summation of the two direct strain components showed a relatively uniform distribution around the restoration and its magnitude equaled approximately to the volumetric shrinkage strain of the material.

In order to understand the spatial development of polymerization shrinkage stress in dental resin-composite restorations, Digital Image Correlation was used to provide full-field displacement/strain measurement of restored model glass cavities by correlating images of the restoration taken before and after polymerization.

牙科复合材料在模拟腔收缩测量与数字图像相关

Polymerization shrinkage of dental resin composites can lead to restoration debonding or cracked tooth tissues in composite-restored teeth. In order to ...

科研

医学

Oral Biofilm Formation on Different Materials for Dental Implants

Dental implants and their prosthetic components are prone to bacterial colonization and biofilm formation. The use of materials that provides low microbial adhesion may reduce the prevalence and progression of peri-implant diseases. In view of the oral environment complexity and oral biofilm heterogeneity, microscopy techniques are needed that can enable a biofilm analysis of the surfaces of teeth and dental materials. This article describes a series of protocols implemented for comparing oral biofilm formation on titanium and ceramic materials for prosthetic abutments, as well as the methods involved in oral biofilms analyses at the morphological and cellular levels. The in situ model to evaluate oral biofilm formation on titanium and zirconia materials for dental prosthesis abutments as described in this study provides a satisfactory preservation of the 48 h biofilm, thereby demonstrating methodological adequacy. Multiphoton microscopy allows the analysis of an area representative of the biofilm formed on the test materials. In addition, the use of fluorophores and the processing of the images using multiphoton microscopy allows the analysis of the bacterial viability in a very heterogeneous population of microorganisms. The preparation of biological specimens for electron microscopy promotes the structural preservation of biofilm, images with good resolution, and no artifacts.

Here, we present a protocol to evaluate oral biofilm formation on titanium and zirconia materials for dental prosthesis abutments, including the analysis of bacterial cells viability and morphological characteristics. An in situ model associated with powerful microscopy techniques is used for the oral biofilm analysis.

牙种植体不同材料的口腔生物膜形成

Dental implants and their prosthetic components are prone to bacterial colonization and biofilm formation. The use of materials that provides low ...

Electromagnetic Navigation Transthoracic Nodule Localization for Minimally Invasive Thoracic Surgery

The increased use of chest computed tomography (CT) has led to an increased detection of pulmonary nodules requiring diagnostic evaluation and/or excision. Many of these nodules are identified and excised via minimally invasive thoracic surgery; however, subcentimeter and subsolid nodules are frequently difficult to identify intra-operatively. This can be mitigated by the use of electromagnetic transthoracic needle localization. This protocol delineates the step-by-step process of electromagnetic localization from the pre-operative period to the postoperative period and is an adaptation of the electromagnetically guided percutaneous biopsy previously described by Arias et al. Pre-operative steps include obtaining a same day CT followed by the generation of a three-dimensional virtual map of the lung. From this map, the target lesion(s) and an entry site are chosen. In the operating room, the virtual reconstruction of the lung is then calibrated with the patient and the electromagnetic navigation platform. The patient is then sedated, intubated, and placed in the lateral decubitus position. Using a sterile technique and visualization from multiple views, the needle is inserted into the chest wall at the prechosen skin entry site and driven down to the target lesion. Dye is then injected into the lesion and, then, continuously during needle withdrawal, creating a tract for visualization intra-operatively. This method has many potential benefits when compared to the CT-guided localization, including a decreased radiation exposure and decreased time between the dye injection and the surgery. Dye diffusion from the pathway occurs over time, thereby limiting intra-operative nodule identification. By decreasing the time to surgery, there is a decrease in wait time for the patient, and less time for dye diffusion to occur, resulting in an improvement in nodule localization. When compared to electromagnetic bronchoscopy, airway architecture is no longer a limitation as the target nodule is accessed via a transparenchymal approach. Details of this procedure are described in a step-by-step fashion.

Presented here is a protocol for lung nodule localization using dye marking via electromagnetically navigated transthoracic needle access. The technique described here can be accomplished in the peri-operative period to optimize nodule localization and to successful resection when performing minimally invasive thoracic surgery.

电磁导航经胸结节定位用于微创胸外科手术

The increased use of chest computed tomography (CT) has led to an increased detection of pulmonary nodules requiring diagnostic evaluation and/or ...

Real-Time Dynamic Navigation System for the Precise Quad-Zygomatic Implant Placement in a Patient with a Severely Atrophic Maxilla

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive bone augmentation and shorten the treatment cycle. However, there are risks associated with the placement of ZIs, such as penetration of the orbital cavity or infra-temporal fossa. Furthermore, the placement of multiple ZIs makes this surgery risky and more difficult to perform. Potential intraoperative complications are extremely dangerous and may cause irreparable losses. Here, we describe a practical, feasible, and reproducible protocol for a real-time surgical navigation system for precisely placing quad-zygomatic implants in the severely atrophic maxilla of patients with residual bone that does not meet the requirements of conventional implants. Hundreds of patients have received ZIs at our department based on this protocol. The clinical outcomes have been satisfactory, the intraoperative and postoperative complications have been low, and the accuracy indicated by infusion of the designed image and postoperative three-dimensional image has been high. This method should be utilized during the entire surgical procedure to ensure ZI placement safety.

Here, we present a protocol to achieve precise quad-zygomatic implant placement in patients with severely atrophic maxilla using a real-time dynamic navigation system.

实时动态导航系统，用于在严重萎缩性上颌骨患者中精确放置四颧植入物

Zygomatic implants (ZIs) are an ideal way to address cases of a severely atrophic edentulous maxilla and maxilla defects because they replace extensive ...

Dynamic Navigation in Endodontics: Guided Access Cavity Preparation by Means of a Miniaturized Navigation System

In the case of teeth with pulp canal calcification (PCC) and apical pathology or pulpitis, root canal treatment can be very challenging. PCC are common sequelae of dental trauma but can also occur with stimuli such as caries, bruxism, or after placing a restoration. In order to access the root canal as minimally invasive as possible in case of a necessary root canal treatment, dynamic navigation has recently been introduced in endodontics in addition to static navigation. The use of a dynamic navigation system (DNS) requires pre-operative cone-beam computed tomography (CBCT) imaging and a digital surface scan. If necessary, reference markers must be placed on the teeth before the CBCT scan; with some systems, these can also be planned and created digitally afterward. By means of a stereo camera connected to the planning software, the drill can now be coordinated with the help of reference markers and virtual planning. As a result, the position of the drill can be displayed on the monitor in real-time during preparation in different planes. In addition, the spatial displacement, the angular deviation, and the depth position are also displayed separately. The few commercially available DNS mostly consist of relatively large camera-marker-systems. Here, the DNS contains miniaturized components: a low-weight camera (97 g) mounted on the micromotor of the electric handpiece utilizing a manufacturer-specific connecting mechanism and a small marker (10 mm x 15 mm), which can be easily attached to an individually manufactured intraoral tray. For research purposes, a post-operative CBCT scan can be matched with the pre-operative one, and the volume of tooth structure removed can be calculated by the software. This work aims to present the technique of guided access cavity preparation by means of a miniaturized navigation system from imaging to clinical implementation.

Dynamic navigation systems (DNS) provide real-time visualization and guidance to the operator during endodontic access cavities preparation. The planning of the procedure requires three-dimensional imaging utilizing cone beam computed tomography and surface scans. After the export of the planning data to the DNS, access cavities can be prepared with minimal invasion.

牙髓病学中的动态导航：通过小型化导航系统进行引导通路腔准备

In the case of teeth with pulp canal calcification (PCC) and apical pathology or pulpitis, root canal treatment can be very challenging. PCC are common ...

A Retrograde Implantation Approach for Peritoneal Dialysis Catheter Placement in Mice

Murine models are employed to probe various aspects of peritoneal dialysis (PD), such as peritoneal inflammation and fibrosis. These events drive peritoneal membrane failure in humans, which remains an area of intense investigation due to its profound clinical implications in managing patients with end-stage kidney disease (ESKD). Despite the clinical importance of PD and its related complications, current experimental murine models suffer from key technical challenges that compromise the models&#39; performance. These include PD catheter migration and kinking and usually warrant earlier catheter removal. These limitations also drive the need for a greater number of animals to complete a study. Addressing these drawbacks, this study introduces technical improvements and surgical nuances to prevent commonly observed PD catheter complications in a murine model. Moreover, this modified model is validated by inducing peritoneal inflammation and fibrosis using lipopolysaccharide injections. In essence, this paper describes an improved method to create an experimental model of PD.

This article describes modifications of a procedure to implant a peritoneal dialysis catheter in a murine model to avoid major technical issues observed with the conventional techniques.

一种小鼠腹膜透析导管放置的逆行植入方法

Murine models are employed to probe various aspects of peritoneal dialysis (PD), such as peritoneal inflammation and fibrosis. These events drive ...

Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities

Pulp canal obliterations (PCO) are often a consequence of dental trauma, such as luxation injuries. Even though dentin apposition is a sign of vital pulp, pulpitis or apical periodontitis may develop in the long term. Root canal treatment of teeth with severe PCO and pulpal or periapical pathosis is challenging for general practitioners and even for well-equipped endodontic specialists. To ensure detection of the calcified root canal and avoid excessive loss of tooth structure or root perforation, static navigation using templates ("Guided Endodontics") was introduced a few years ago. The general workflow includes three-dimensional imaging using cone-beam computed tomography (CBCT), a digital surface scan, and superimposition of both in a planning software. This is followed by virtual planning of the access cavity and the design of a template that will guide the drill to the desired target point. To do this, a true-to-scale virtual image of the drill must be placed in a way that the tip of the drill reaches the orifice of the calcified root canal. Once the template has been fabricated using computer-aided design and computer-aided manufacturing (CAD/CAM) or a 3D printer, guided preparation of the access cavity can be performed clinically. For research purposes, a postoperative CBCT image can be used to quantify the accuracy of the access cavity performed. This work aims to present the technique of static guided endodontics from imaging to clinical implementation.

Guided endodontics describes a template-aided approach for access cavity preparation. The procedure requires cone-beam computed tomography and a surface scan to produce a template. An incorporated sleeve guides the drill to the target point. This allows the preparation of minimally invasive endodontic access cavities in calcified teeth.

引导牙髓病学：牙髓通路腔的三维规划和模板辅助制备

Pulp canal obliterations (PCO) are often a consequence of dental trauma, such as luxation injuries. Even though dentin apposition is a sign of vital pulp, ...

Augmented Reality Navigation-Guided Core Decompression for Osteonecrosis of Femoral Head

Osteonecrosis of the femoral head (ONFH) is a common joint disease in young and middle-aged patients, which seriously burdens their lives and work. For early-stage ONFH, core decompression surgery is a classical and effective hip preservation therapy. In traditional procedures of core decompression with Kirschner wire, there are still many problems such as X-ray exposure, repeated puncture verification, and damage to normal bone tissue. The blindness of the puncture process and the inability to provide real-time visualization are crucial reasons for these problems.
To optimize this procedure, our team developed an intraoperative navigation system on the basis of augmented reality (AR) technology. This surgical system can intuitively display the anatomy of the surgical areas and render preoperative images and virtual needles to intraoperative video in real-time. With the guide of the navigation system, surgeons can accurately insert Kirschner wires into the targeted lesion area and minimize the collateral damage. We conducted 10 cases of core decompression surgery with this system. The efficiency of positioning and fluoroscopy is greatly improved compared to the traditional procedures, and the accuracy of puncture is also guaranteed.

Augmented reality technology was applied to core decompression for osteonecrosis of the femoral head to realize real-time visualization of this surgical procedure. This method can effectively improve the safety and precision of core decompression.

增强现实导航引导的股骨头坏死核心减压

Osteonecrosis of the femoral head (ONFH) is a common joint disease in young and middle-aged patients, which seriously burdens their lives and work. For ...

Muscle Function Obtained with Motion Mode Ultrasound and Surface Electromyography during Core Endurance Exercise

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured between fascial borders at a given time point during an exercise. This selected time point produces a one-dimensional image resulting in real-time, live observation of anatomy. Ultrasound used during functional movement can be referred to as dynamic ultrasound; this is feasible and reliable with the use of a linear transducer, elastic belt, and foam block to secure consistent transducer placement. The lateral abdominal wall is commonly investigated using ultrasound due to the overlapping nature of the muscles. Surface electromyography (sEMG) can complement M-mode ultrasound imaging because it measures the electrical representation of muscle activation. There is minimal evidence using M-mode ultrasound and sEMG simultaneously during core exercise. Exercises that challenge the core musculature involve both isometric holds (e.g., side plank), as well as oscillatory extremity movements (e.g., dead bug). In this study, both instruments will be used simultaneously to measure core muscle function during exercise. Ultrasound measurements will be obtained using a linear transducer and ultrasound unit, and sEMG measurements will be acquired from a wireless sEMG system. To make comparisons between participants and exercises, normalization methods using static, exercise starting positions for both instruments will be used. An activation ratio will be used for ultrasound and calculated by dividing the contracted thickness (thickness during a time point of exercise) by the rested (starting position) thickness. Muscle thickness will be measured in centimeters from the superior inferior fascial border to inferior superior fascial border. These methods aim to offer an innovative and practical measurement of muscle function with M-mode ultrasound and sEMG during core endurance exercises.

This protocol uses motion mode ultrasound and surface electromyography simultaneously to measure muscle function of the core. Muscle thickness and activation of the local stabilizers (e.g., transverse abdominis, internal oblique) and global movers (e.g., external oblique) is achievable during specific time points of the side plank and dead bug exercises.

核心耐力运动期间通过运动模式超声和表面肌电图获得的肌肉功能

Motion mode (M-mode) ultrasound allows researchers and clinicians to measure the change of muscle thickness across time. Muscle thickness can be measured ...

Semi-Automated Planimetric Quantification of Dental Plaque Using an Intraoral Fluorescence Camera

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI),&#160;which measures the relative area of a tooth that is covered by plaque deposits. Compared to clinical indices, the PPI has a higher discriminatory power, but traditional planimetry is a time-consuming analysis, as the plaque-covered and clean tooth areas have to be determined manually for each image using image-processing software. Here, we present a method for the semi-automated planimetric quantification of dental plaque, which allows for the rapid processing of up to 1,000 images simultaneously. The method exploits the enhanced contrast between disclosed plaque, sound tooth surfaces, and soft tissues in fluorescence images acquired with an intraoral camera. Careful execution of the clinical procedures and accurate image acquisition are crucial steps for the successful semi-automated identification of the plaque-covered areas. The method is suitable for planimetry on sound facial and oral tooth surfaces, on most composite resin restorations, and on teeth with orthodontic brackets, but not on metallic restorations. Compared to traditional PPI recordings, semi-automated planimetry considerably reduces the amount of time spent on the analysis, as well as the subjective human input, thus increasing the reproducibility of planimetric measurements.

This study presents a semi-automated digital image analysis procedure for the planimetric quantification of disclosed dental plaque based on images acquired with an intraoral fluorescence camera. The method allows for the rapid and reliable quantification of dental plaque in the research environment.

使用口内荧光相机对牙菌斑进行半自动平面定量

Dental plaque accumulation is quantified using clinical indices or, otherwise, the planimetric plaque index (PPI),&#160;which measures the relative area ...