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

이 연구는 공공, 상업 또는 비영리 부문의 자금 지원 기관으로부터 특정 보조금을받지 못했습니다.

수술 전에 모든 환자로부터 정보에 입각 한 동의를 얻었습니다. 개입 후 익명화 된 후 향적 데이터가이 연구에 사용되었습니다.
1. 라벨이 부착된 클립 보정 방법을 사용하는 동적 내비게이션 시스템의 기존 워크플로 단계(톱니가 있는 턱뼈에만 사용):
<ol><li>열가소성 재료를 사용하여 치료를 수행할 턱뼈(상악/하악)의 치아에 방사선 불투과성 고정 클립을 부착?...

<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>

레이블이 지정된 클립 사용 동적 탐색 임플란트 배치 시스템에서 기존 워크플로는 클립 보정으로 수행됩니다. 클립 표면에는 CBCT 스캔에서 명확하게 볼 수있는 세 개의 방사선 불 투과성 금속 구체가 있습니다. 트레이서 교정 방법의 경우 클립이 포함된 이러한 금속 구체는 CBCT 스캐닝이나 시스템 보정에 필요하지 않습니다. 기존 톱니가 있는 경우 레이블이 지정된 클립과 레이블이 지정되지 않은...

치과 임플란트 식립의 정확성을 높이고 합병증을 줄이기 위해 영상 연구를 기반으로 한 다양한 탐색 기술이 개발되었습니다. 수술 전 영상 및 특수 3D 임플란트 계획 소프트웨어를 사용하여 치과 임플란트 1,2의 정확한 위치를 계획할 수 있습니다.
임플란트 수술 탐색의 목적은 가능한 의원성 합병증(신경, 혈관, 뼈 및 부비동 손상)의 위험을 줄이기 위해 가장 이상적인 위치를 달성하기 위해 치과 임플란트의 해부학적으로 보다 정확한 배치를 달성하는 것입니다. 탐색 수술은 중재의 침습성을 감소시켜 (플랩리스 수술) 불만을 줄이고 회복을 가속화 할 수 있습니다. 정확한 임플란트 식립은 사전 보철 계획(수술 전 치아 설치를 기반으로 수술을 수행할 수 있음)을 기반으로 하며 최적의 임플란트 위치는 뼈 이식을 방지하는 데 도움이 될 수 있습니다.
오늘날 컴퓨터 보조 임플란트(CAI) 수술 배치 내비게이션 시스템에는 정적 및 동적 내비게이션 시스템의 두 가지 유형이 있습니다. 정적 탐색은 사전 계획되고 조립식 수술 템플릿을 사용하는 제어된 임플란트 식립 방법입니다. 동적 탐색은 광학 제어를 사용하는 수술 템플릿 없이 미리 계획된 컴퓨터 유도 임플란트 수술 배치 방법입니다. 제어 절차는 포인트 클라우드 기반 이미지 정합을 사용하여 3D 이미지 오버레이3를 적용하여 가상 이미지를 실제 환경과 병합합니다.
DCAI 시스템은 GPS와 유사한 프레임워크 내에서 실시간으로 객관화된 기기 제어를 가능하게 합니다. 전형적으로, 이들은 광학 추적을 사용하여 환자 및 수술 기구 위에 배치된 (광학적) 참조 마커의 위치를 검출 및 추적하고, 임플란트 수술 배치 프로세스(1,2)에 대한 지속적인 시각적 피드백을 제공한다.
수술 중 수술 기구의 움직임과 위치를 모니터의 3차원 이미지로 실시간으로 모니터링할 수 있습니다. 시술 중에 카메라 시스템을 통해 환자의 턱뼈 위치와 수술 도구의 위치를 지속적으로 모니터링하고 비교할 수 있습니다.
동적 네비게이션 시스템에는 두 가지 유형이 있습니다 : 하나는 수동 시스템이며,이 경우 등록 장치 (기준베이스)는 광원에서 방출 된 빛을 스테레오 카메라로 다시 반사합니다. 다른 하나는 활성 시스템이며, 여기서 등록 장치는 스테레오 카메라(4,5)가 뒤따르는 빛을 방출합니다.
다음 단계의 동적 내비게이션 시스템은 서보 모터를 사용하여 촉각 자극으로 외과 의사의 손을 안내하므로 로봇 팔이있는 장치가 외과 의사의 움직임을 결정하거나 먼 미래에 완전히 교체 할 수 있습니다 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

현대 임플란트학에서 수술 용 네비게이션 시스템의 적용이 점점 더 중요 해지고 있습니다. 정적 수술 탐색 방법 외에도 가이드 독립적 동적 탐색 임플란트 식립 절차가 점점 더 널리 보급되고 있습니다. 이 절차는 광학 제어를 사용하는 컴퓨터 유도 치과 임플란트 식립을 기반으로합니다. 이 작업은 새로운 컴퓨터지원 임플란트 수술 (DCAIS) 시스템 (설계, 보정, 수술)의 기술적 단계를 시연하고 결과의 정확성을 확인하는 것을 목표로합니다. 원뿔 빔 컴퓨터 단층 촬영(CBCT) 스캔을 기반으로 임플란트의 정확한 위치는 전용 소프트웨어로 결정됩니다. 작동의 첫 번째 단계는 내비게이션 시스템의 보정으로, 1) 마커로 촬영 한 CBCT 이미지를 기반으로 또는 2) 마커가없는 CBCT 이미지를 기반으로하는 두 가지 방법으로 수행 할 수 있습니다. 임플란트는 수술 전 계획에 따라 실시간 탐색을 통해 삽입됩니다. 중재의 정확성은 수술 후 CBCT 이미지를 기반으로 평가할 수 있습니다. 임플란트의 계획된 위치를 포함하는 수술 전 이미지와 수술 후 CBCT 이미지는 임플란트의 각도 (정도), 플랫폼 및 정점 편차 (mm)를 기반으로 비교되었습니다. 데이터를 평가하기 위해 계획되고 수행된 임플란트 위치 내 편차의 표준편차(SD), 평균 및 평균(SEM)의 표준오차를 계산했다. 이 데이터를 기반으로 두 교정 방법의 차이점을 비교했습니다. 지금까지 수행 된 중재를 기반으로 DCAIS를 사용하면 고정밀 임플란트 배치가 가능합니다. 라벨링된 CBCT 기록이 필요하지 않은 교정 시스템은 라벨링을 사용하는 시스템과 유사한 정확도로 외과적 개입을 허용합니다. 개입의 정확성은 훈련을 통해 향상 될 수 있습니다.

DCAIS를 올바르게 사용하려면 시스템을 보정해야 합니다. 임플란트 배치의 정확도에 영향을 줄 수있는 몇 가지 교정 방법이 있습니다. 이 연구는 DCAIS의 정확도에 대한 다양한 교정 방법의 잠재적 영향을 평가하는 것을 목표로 했습니다.
지금까지 수행 된 중재를 기반으로 DCAIS를 사용하면 고정밀 임플란트 배치가 가능합니다. 초기 연구에서 우리는 41개의 클립 보정된 동적 탐?...

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

Dynamic Navigation for Dental Implant Placement

동적 컴퓨터 보조 임플란트 수술(DCAIS)은 광학 제어를 사용하여 수술 템플릿 없이 수행되는 제어된 임플란트 수술 배치 방법입니다. 수술 장치의 움직임과 위치에 대한 실시간 수술 중 제어는 절차를 단순화하고 외과의에게 더 많은 자유를 제공하여 정적 탐색 방법과 유사한 정밀도를 제공합니다.

치과 임플란트 식립을 위한 동적 탐색

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

디지털 컴퓨터 임플란트 시스템은 GPS와 같은 프레임워크 내에서 실시간 객관화된 기기 제어를 가능하게 합니다. 수술 중 기구의 위치는 모니터의 3차원 이미지로 실시간으로 모니터링할 수 있습니다. 이 기술은 정확하고 최소 침습적이며 수술 가이드 템플릿이 필요하지 않으며 작은 입에서 사용하기 쉽습니다.계획과 수술은 당일 수행 할 수 있으며 수술 중 수정이 가능합니다. 실제 상황에서 사용하기 전에 치과 이미지에서 방법을 연습하는 것이 좋습니다. 이 절차는 우리 부서의 조교수 인 Tamas Huszar가 시연 할 것입니다.열가소성 소재를 사용하여 치료 부위의 턱뼈 치아에 라디오 팩 고정 클립을 부착하여 시작하십시오. 입안에 라벨이 붙은 클립으로 환자의 콘 빔 컴퓨터 단층 촬영 또는 CBCT 검사를하십시오. 적절한 소프트웨어를 사용하여 보철 아키텍처에 따라 임플란트의 위치를 계획하십시오.핸드피스에 삽입된 핸드피스 척과 회전 마커 디스크를 보정하여 헤드피스를 등록합니다. 그런 다음 환자 추적기와 레이블이 지정된 클립 사이에 암을 조립하고 보정합니다. 장치 보정을 확인하려면 임플란트 배치가 발생할 턱에 광학 마커 또는 추적기를 고정하는 레이블이 지정된 클립을 고정하십시오.수술 전 CBCT에 등록된 동일한 위치에 클립을 삽입해야 합니다. 그런 다음 프로브의 피벗으로 클립의 금속 구를 터치하여 레이블이 지정된 클립을 보정합니다. 탐색 임플란트 식립 및 국소 마취를 수행하려면 드릴 길이를 측정하고 실시간 시각적 정확도를 확인하십시오.드릴링의 진입 점을 결정하고 플랩없이 작업 현장을 탐색하십시오. 다음으로 동적 탐색 제어로 뼈를 뚫습니다. 임플란트 길이를 측정한 후, 다이내믹 네비게이션 시스템 제어 추적기를 착용한 핸드피스와 함께 임플란트를 배치한다.5/0 모노 필라멘트 비 흡수성 폴리 프로필렌 봉합사로 상처를 닫거나 조립식 보철 작업을 고정하십시오. 그런 다음 제어 방사선 이미지를 획득합니다. 입안에 클립없이 환자에게 CBCT를 수행하십시오.적절한 소프트웨어를 사용하여 보철 아키텍처에 따라 임플란트의 위치를 계획하고 앞에서 설명한 대로 장치를 보정합니다. 라벨이 부착된 클립 없이 시스템을 교정하려면 임플란트의 외과적 배치 계획을 내비게이션 시스템 소프트웨어로 전송합니다. 그런 다음 내비게이션 소프트웨어의 3차원 CT 이미지에서 작업 공간을 선택합니다.라벨이없는 클립으로 치아에 추적기를 고정하거나 무치악 턱의 경우 특수 추적기 고정 암을 고정하십시오. 그런 다음 내비게이션 시스템의 3D CT 이미지에서 최소 3개의 일반적인 해부학적 지점을 선택합니다. 입안에서 선택한 해부학 적 지점을 프로브 도구로 만져서 확인하십시오.프로브로 해부학 적 구조의 표면을 그려 3-4 개의 영역에서 정제 절차를 수행하십시오. 국소 마취하에 임플란트를 탐색과 함께 놓고 드릴 길이를 측정하십시오. 드릴링 지점을 결정하고 플랩 없이 수술 부위를 탐색하기 전에 치아 또는 뼈 표면의 실시간 시각적 정확도를 확인하십시오.동적 탐색 제어로 뼈를 뚫습니다. 동적 탐색 제어 추적기를 착용한 핸드피스와 함께 임플란트를 삽입하기 전에 임플란트 길이를 측정합니다. 5/0 모노필라멘트 비흡수성 폴리프로필렌 봉합사로 상처를 닫거나 조립식 보철 작업을 고정하십시오.그런 다음 제어 방사선 영상을 시작하십시오. 초기 연구의 데이터는 플랫폼과 협측 언어 및 중간 원위 방향의 각도 편차 사이에 유의 한 상관 관계가 없음을 보여주었습니다. 임플란트의 계획된 위치와 최종 위치를 비교했을 때 클립 보정 방법은 트레이서 보정 방법에 비해 큰 차이 없이 더 정확했습니다.교정의 연속성과 절차 추적을 확인하는 것이 중요합니다. 시스템이 오작동 신호를 보냅니다. 이 절차는 뿌리 정점 절단, 양악 수술, 근관 치료 절차 또는 복잡한 사랑니 제거와 같은 여러 추적 치과 치료를 허용합니다.

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.

시뮬레이션 구멍 치과 복합의 수축은 디지털 이미지의 상관 관계로 측정

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

연구

의학

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.

치과 임 플 란 트에 대 한 다른 자료에 구두 Biofilm 형성

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.

최소 침습적 흉부 수술을 위한 전자기 네비게이션 흉부 결절 국소화

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.

중증 위축성 상악 환자의 정확한 사중 접합체 임플란트 배치를 위한 실시간 동적 탐색 시스템

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.

근관 치료의 동적 내비게이션: 소형화된 내비게이션 시스템을 통한 접근 캐비티 준비 안내

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.

마우스의 복막 투석 카테터 배치를 위한 역행 이식 접근법

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.

유도 근관 치료: 근관 접근 공동의 3차원 계획 및 템플릿 지원 준비

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.

증강 현실 탐색 유도 대퇴골 머리의 골괴사에 대한 코어 감압

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.

운동 모드 초음파와 표면 근전도 검사로 얻은 근육 기능 코어 지구력 운동 중

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.

구강 내 형광 카메라를 사용한 치태의 반자동 평면 정량

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