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

Denne forskning modtog ikke noget specifikt tilskud fra finansieringsorganer i den offentlige, kommercielle eller non-profit sektor.

Der blev indhentet informeret samtykke fra alle patienter før operationen. Efter interventionerne blev anonymiserede retrospektive data brugt i denne undersøgelse.
1. Trin i den traditionelle arbejdsgang for dynamiske navigationssystemer ved hjælp af mærket klipkalibreringsmetode (kun til brug på kæbeben med tænder):
<ol><li>Fastgør en radioaktiv fikseringsclips til tænderne på kæbebenet, hvor behandlingen skal udføres (maxilla / mandible) ved hjælp af et termop...

<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>

I det mærkede klipbrugte dynamiske navigationsimplantatplaceringssystem udføres den traditionelle arbejdsgang ved klipkalibrering. Der er tre radioaktive metalkugler på overfladen af klippet, som er tydeligt synlige på CBCT-scanningen. I tilfælde af sporkalibreringsmetoden er disse metalkugler, der indeholder clips, hverken nødvendige for CBCT-scanning eller systemkalibrering. I tilfælde med eksisterende tænder kan både de mærkede og umærkede klip anvendes (to forskellige kalibreringsmetoder). Klemmen er fastg...

For at øge nøjagtigheden af tandimplantatplacering og reducere komplikationerne er der udviklet en række navigationsteknikker baseret på billeddannelsesundersøgelser. Præoperativ billeddannelse og speciel 3D-implantatplanlægningssoftware kan bruges til at planlægge den nøjagtige position af tandimplantatet 1,2.
Formålet med implantatkirurgi navigation er at opnå en mere anatomisk præcis placering af tandimplantatet for at opnå den mest ideelle position for at reducere risikoen for mulige iatrogene komplikationer (nerve-, vaskulære, knogle- og bihuleskader). Den navigerede kirurgi nedsætter interventionens invasivitet (flapless kirurgi), hvilket kan føre til færre klager og hurtigere genopretning. Den nøjagtige implantatplacering er baseret på forudgående proteseplanlægning (det er muligt at udføre operationen på basis af en præoperativ tandinstallation), og den optimale implantatpositionering kan hjælpe med at undgå knogletransplantation.
I dag er der to typer computerassisterede implantat (CAI) kirurgiske placeringsnavigationssystemer - statiske og dynamiske navigationssystemer. Statisk navigation er en kontrolleret implantatplaceringsmetode ved hjælp af en forudplanlagt og præfabrikeret kirurgisk skabelon. Dynamisk navigation er en forudplanlagt computerstyret implantatkirurgisk placeringsmetode uden en kirurgisk skabelon ved hjælp af optisk kontrol. Kontrolproceduren bruger punktskybaseret billedregistrering til at flette de virtuelle billeder med det virkelige miljø ved at anvende 3D-billedoverlejring3.
DCAI-systemer muliggør objektiveret instrumentstyring i realtid inden for en GPS-lignende ramme. Typisk bruger de optisk sporing til at detektere og spore placeringen af (optiske) referencemarkører placeret over patienten og de kirurgiske instrumenter og give kontinuerlig visuel feedback om implantatets kirurgiske placeringsproces 1,2.
Bevægelsen og placeringen af det kirurgiske instrument under operationen kan overvåges live på et tredimensionelt billede på en skærm. Under proceduren tillader kamerasystemet kontinuerlig overvågning og sammenligning af placeringen af patientens kæbeben og placeringen af det kirurgiske instrument.
Der er to typer dynamiske navigationssystemer: den ene er det passive system, i hvilket tilfælde registreringsenhederne (referencebaser) reflekterer lys, der udsendes fra lyskilden, tilbage til stereokameraerne; Den anden er det aktive system, hvor registreringsenhederne udsender lys, som efterfølges af stereokameraer 4,5.
Det næste niveau af dynamiske navigationssystemer bruger servomotorer til at styre kirurgens hånd med taktile stimuli, så enheden med robotarme kan bestemme kirurgens bevægelser eller endda erstatte dem helt i den fjerne fremtid 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

I moderne implantologi bliver anvendelsen af kirurgiske navigationssystemer stadig vigtigere. Ud over statiske kirurgiske navigationsmetoder bliver en guideuafhængig dynamisk navigationsimplantatplaceringsprocedure mere udbredt. Proceduren er baseret på computerstyret tandimplantatplacering ved hjælp af optisk kontrol. Dette arbejde har til formål at demonstrere de tekniske trin i et nytdynamisk computerstøttet implantatkirurgi (DCAIS) system (design, kalibrering, kirurgi) og kontrollere nøjagtigheden af resultaterne. Baseret på cone-beam computertomografi (CBCT) scanninger bestemmes implantaternes nøjagtige positioner med dedikeret software. Det første trin i operationen er kalibrering af navigationssystemet, som kan udføres på to måder: 1) baseret på CBCT-billeder taget med en markør eller 2) baseret på CBCT-billeder uden markører. Implantater indsættes ved hjælp af realtidsnavigation i henhold til de præoperative planer. Nøjagtigheden af interventionerne kan evalueres baseret på postoperative CBCT-billeder. De præoperative billeder, der indeholdt implantaternes planlagte positioner og postoperative CBCT-billeder, blev sammenlignet baseret på implantaternes vinkling (grad), platform og apikale afvigelse (mm). For at evaluere dataene beregnede vi standardafvigelsen (SD), middelværdien og standardfejlen for middelværdien (SEM) af afvigelser inden for planlagte og udførte implantatpositioner. Forskelle mellem de to kalibreringsmetoder blev sammenlignet baseret på disse data. Baseret på de interventioner, der er udført indtil videre, giver brugen af DCAIS mulighed for implantatplacering med høj præcision. Et kalibreringssystem, der ikke kræver mærket CBCT-optagelse, giver mulighed for kirurgisk indgreb med samme nøjagtighed som et system, der bruger mærkning. Interventionens nøjagtighed kan forbedres ved træning.

For at bruge DCAIS korrekt skal systemet kalibreres. Der er flere kalibreringsmetoder, der kan påvirke nøjagtigheden af implantatplaceringen. Denne undersøgelse havde til formål at vurdere den potentielle indvirkning af forskellige kalibreringsmetoder på nøjagtigheden af DCAIS.
Baseret på de interventioner, der er udført indtil videre, tillader brugen af DCAIS en implantatplacering med høj præcision. I vores tidlige undersøgelser sammenlignede vi 41 klipkalibrerede dynamiske naviger...

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

Dynamic Navigation for Dental Implant Placement

Dynamisk computerstøttet implantatkirurgi (DCAIS) er en kontrolleret implantatkirurgisk placeringsmetode, der udføres uden en kirurgisk skabelon ved hjælp af optisk kontrol. Den intraoperative kontrol i realtid af bevægelse og position af det kirurgiske udstyr forenkler proceduren og giver mere frihed til kirurgen, hvilket giver lignende præcision som statiske navigationsmetoder.

Dynamisk navigation til placering af tandimplantater

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

Digitale computeriserede implantatsystemer muliggør objektiveret instrumentstyring i realtid inden for en GPS-lignende ramme. Instrumentets position under operationen kan overvåges live på et tredimensionelt billede på en skærm. Denne teknik er præcis, minimal invasiv, behøver ikke en kirurgisk vejledningsskabelon og nem at bruge i en lille mund.Planlægningen og operationen kan udføres samme dag, og ændring er mulig under operationen. Det anbefales at øve metoden på et tandbillede, før du bruger det i en levende situation. Proceduren vil blive demonstreret af Tamas Huszar, en adjunkt fra vores afdeling.Begynd med at fastgøre en radiopakkefikseringsclips til kæbebenets tænder på behandlingsstedet ved hjælp af et termoplastisk materiale. Lav en keglestråle computertomografi eller CBCT-undersøgelse af patienten med et mærket klip i munden. Planlæg implantatets position i henhold til protesearkitekturen med den relevante software.Registrer hovedstykket ved at kalibrere håndstykkechucken og den roterende markørskive, der er indsat i håndstykket. Saml derefter armen mellem patienttrackeren og den mærkede klemme, og kalibrer den. For at kontrollere enhedens kalibrering skal du rette den mærkede klemme, der holder den optiske markør eller tracker på tænderne, på hvilken kæbe implantatplaceringen vil forekomme.Sørg for at indsætte klippet i samme position, der er registreret på den præoperative CBCT. Rør derefter ved clipsens metalkugler med sondens drejning for at kalibrere det mærkede klip. For at udføre den navigerede implantatplacering og lokalbedøvelse skal du måle borelængden og kontrollere den visuelle nøjagtighed i realtid.Bestem indgangspunktet for boringen, og udforsk operationsstedet uden klappen. Bor derefter knoglen med dynamisk navigationskontrol. Når du har målt implantatlængden, skal du placere implantatet med håndstykket iført den dynamiske navigationssystemstyrede tracker.Luk såret med 5/0 monofilament ikke-absorberbar polypropylensutur eller fastgør det præfabrikerede protesearbejde. Derefter erhverve et kontrol radiologisk billede. Udfør CBCT på patienten uden et klip i munden.Brug passende software til at planlægge implantatets position i henhold til protesearkitekturen og kalibrere enheden som beskrevet tidligere. For at kalibrere systemet uden et mærket klip skal du overføre planen for kirurgisk placering af implantatet til navigationssystemets software. Vælg derefter arbejdsområdet på det tredimensionelle CT-billede af navigationssoftwaren.Fastgør trackeren på tænderne med et umærket klip, eller i tilfælde af en edentulous kæbe skal du rette en speciel tracker-holdearm. Vælg derefter mindst tre typiske anatomiske punkter på et 3D CT-billede af navigationssystemet. Identificer de valgte anatomiske punkter i munden ved at røre dem med et sondeværktøj.Udfør forfiningsproceduren på tre til fire områder ved at tegne på overfladen af den anatomiske struktur med en sonde. Under lokalbedøvelse skal du placere implantatet med navigation og måle borelængden. Kontroller tandens eller knoglens visuelle nøjagtighed i realtid, før du bestemmer borepunktet og udforsker operationsstedet uden klappen.Bor knoglen med dynamisk navigationskontrol. Mål implantatlængden, før du placerer implantatet med håndstykket iført den dynamiske navigationsstyrede tracker. Luk såret med en 5/0 monofilament ikke-absorberbar polypropylensutur, eller fastgør det præfabrikerede protesearbejde.Start derefter kontrol radiologisk billeddannelse. Dataene fra den tidlige undersøgelse viste, at der ikke var nogen signifikant sammenhæng mellem platformen og vinkelafvigelsen i buccolingual og mesiodistal retninger. Da implantaternes planlagte og endelige position blev sammenlignet, viste klipkalibreringsmetoden sig mere nøjagtig sammenlignet med sporkalibreringsmetoden uden nogen signifikant forskel.Det er vigtigt at kontrollere kontinuiteten i kalibreringen og sporingen af proceduren. Systemet signalerer enhver funktionsfejl. Proceduren giver mulighed for en række sporede tandbehandlinger, såsom amputation af rodspidser, ortognatisk kirurgi, endodontiske procedurer eller kompliceret fjernelse af visdomstand.

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.

Krympning af Dental Composite i simuleret Cavity Målt med 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 ...

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.

Mundtlige Biofilmdannelse på forskellige materialer til tandimplantater

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.

Elektromagnetisk navigation Transthoracic Nodule Lokalisering til minimalt invasiv thoraxkirurgi

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.

Dynamisk navigationssystem i realtid til præcis quad-zygomatisk implantatplacering hos en patient med en alvorligt atrofisk maxilla

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.

Dynamisk navigation i endodonti: Guidet adgang hulrum forberedelse ved hjælp af et miniaturiseret navigationssystem

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.

En retrograd implantationsmetode til peritonealdialysekateterplacering hos mus

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.

Guidet endodonti: Tredimensionel planlægning og skabelonstøttet forberedelse af endodontiske adgangshulrum

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.

Augmented Reality Navigationsstyret kernedekompression til osteonekrose af lårbenshovedet

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.

Muskelfunktion opnået med bevægelsestilstand ultralyd og overfladeelektromyografi under core udholdenhedstræning

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.

Halvautomatisk planimetrisk kvantificering af plak ved hjælp af et intraoralt fluorescenskamera

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