scholarly journals An Integrated Computer-Aided Robotic System for Dental Implantation

2011 ◽  
Author(s):  
Xiaoyan Sun ◽  
Yongki Yoon ◽  
Jiang Li ◽  
Frederic D. McKenzie
Keyword(s):  
Preoperative Planning ◽  
Robotic System ◽  
Integrated System ◽  
Patient Specific ◽  
Registration Accuracy ◽  
Coordinate Measurement ◽  
Registration Errors ◽  
Dental Implantation ◽  
Computer Aided ◽  
Preoperative Plan

This paper describes an integrated system for dental implantation including both preoperative planning utilizing computer-aided technology and automatic robot operation during the intra-operative stage. A novel two-step registration procedure was applied for transforming the preoperative plan to the operation of the robot, with the help of a Coordinate Measurement Machine (CMM). Experiments with a patient-specific phantom were carried out to evaluate the registration error for both position and orientation. After adopting several improvements, registration accuracy of the system was significantly improved. Sub-millimeter accuracy with the Target Registration Errors (TREs) of 0.38±0.16 mm (N=5) was achieved. The target orientation errors after registration and after phantom drilling were 0.92±0.16 ° (N=5) and 1.99±1.27 ° (N=14), respectively. These results permit the ultimate goal of an automated robotic system for dental implantation.

scholarly journals Three-dimensional preoperative planning in the weight-bearing state: validation and clinical evaluation

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Tabitha Roth ◽  
Fabio Carrillo ◽  
Matthias Wieczorek ◽  
Giulia Ceschi ◽  
Hooman Esfandiari ◽  
...  
Keyword(s):  
Clinical Evaluation ◽  
Preoperative Planning ◽  
Mechanical Axis ◽  
Weight Bearing ◽  
3D Models ◽  
Joint Line ◽  
Patient Specific ◽  
Registration Accuracy ◽  
Convergence Angle ◽  
Joint Line Convergence Angle

Abstract Objectives 3D preoperative planning of lower limb osteotomies has become increasingly important in light of modern surgical technologies. However, 3D models are usually reconstructed from Computed Tomography data acquired in a non-weight-bearing posture and thus neglecting the positional variations introduced by weight-bearing. We developed a registration and planning pipeline that allows for 3D preoperative planning and subsequent 3D assessment of anatomical deformities in weight-bearing conditions. Methods An intensity-based algorithm was used to register CT scans with long-leg standing radiographs and subsequently transform patient-specific 3D models into a weight-bearing state. 3D measurement methods for the mechanical axis as well as the joint line convergence angle were developed. The pipeline was validated using a leg phantom. Furthermore, we evaluated our methods clinically by applying it to the radiological data from 59 patients. Results The registration accuracy was evaluated in 3D and showed a maximum translational and rotational error of 1.1 mm (mediolateral direction) and 1.2° (superior-inferior axis). Clinical evaluation proved feasibility on real patient data and resulted in significant differences for 3D measurements when the effects of weight-bearing were considered. Mean differences were 2.1 ± 1.7° and 2.0 ± 1.6° for the mechanical axis and the joint line convergence angle, respectively. 37.3 and 40.7% of the patients had differences of 2° or more in the mechanical axis or joint line convergence angle between weight-bearing and non-weight-bearing states. Conclusions Our presented approach provides a clinically feasible approach to preoperatively fuse 2D weight-bearing and 3D non-weight-bearing data in order to optimize the surgical correction.

Full tractography for detecting the position of cranial nerves in preoperative planning for skull base surgery: technical note

2020 ◽  
Vol 132 (5) ◽  
pp. 1642-1652 ◽  
Author(s):  
Timothee Jacquesson ◽  
Fang-Chang Yeh ◽  
Sandip Panesar ◽  
Jessica Barrios ◽  
Arnaud Attyé ◽  
...  
Keyword(s):  
Skull Base ◽  
Preoperative Planning ◽  
Skull Base Surgery ◽  
Cranial Nerves ◽  
Patient Specific ◽  
Small Scale ◽  
Skull Base Tumor ◽  
Skull Base Tumors ◽  
Brain White Matter ◽  
Human Connectome Project

OBJECTIVEDiffusion imaging tractography has allowed the in vivo description of brain white matter. One of its applications is preoperative planning for brain tumor resection. Due to a limited spatial and angular resolution, it is difficult for fiber tracking to delineate fiber crossing areas and small-scale structures, in particular brainstem tracts and cranial nerves. New methods are being developed but these involve extensive multistep tractography pipelines including the patient-specific design of multiple regions of interest (ROIs). The authors propose a new practical full tractography method that could be implemented in routine presurgical planning for skull base surgery.METHODSA Philips MRI machine provided diffusion-weighted and anatomical sequences for 2 healthy volunteers and 2 skull base tumor patients. Tractography of the full brainstem, the cerebellum, and cranial nerves was performed using the software DSI Studio, generalized-q-sampling reconstruction, orientation distribution function (ODF) of fibers, and a quantitative anisotropy–based generalized deterministic algorithm. No ROI or extensive manual filtering of spurious fibers was used. Tractography rendering was displayed in a tridimensional space with directional color code. This approach was also tested on diffusion data from the Human Connectome Project (HCP) database.RESULTSThe brainstem, the cerebellum, and the cisternal segments of most cranial nerves were depicted in all participants. In cases of skull base tumors, the tridimensional rendering permitted the visualization of the whole anatomical environment and cranial nerve displacement, thus helping the surgical strategy.CONCLUSIONSAs opposed to classical ROI-based methods, this novel full tractography approach could enable routine enhanced surgical planning or brain imaging for skull base tumors.

3D Printing & Pharmaceutical Manufacturing: Opportunities and Challenges

2016 ◽  
Vol 5 (01) ◽  
pp. 4723 ◽  
Author(s):  
Bhusnure O. G.* ◽  
Gholve V. S. ◽  
Sugave B. K. ◽  
Dongre R. C. ◽  
Gore S. A. ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Tissue Engineering ◽  
3D Printing ◽  
Computer Aided Design ◽  
Patient Specific ◽  
Computer Design ◽  
3D Scaffolds ◽  
Engineering Research ◽  
Advantages And Disadvantages ◽  
Computer Aided

Many researchers have attempted to use computer-aided design (C.A.D) and computer-aided manufacturing (CAM) to realize a scaffold that provides a three-dimensional (3D) environment for regeneration of tissues and organs. As a result, several 3D printing technologies, including stereolithography, deposition modeling, inkjet-based printing and selective laser sintering have been developed. Because these 3D printing technologies use computers for design and fabrication, and they can fabricate 3D scaffolds as designed; as a consequence, they can be standardized. Growth of target tissues and organs requires the presence of appropriate growth factors, so fabrication of 3Dscaffold systems that release these biomolecules has been explored. A drug delivery system (D.D.S) that administrates a pharmaceutical compound to achieve a therapeutic effect in cells, animals and humans is a key technology that delivers biomolecules without side effects caused by excessive doses. 3D printing technologies and D. D. Ss have been assembled successfully, so new possibilities for improved tissue regeneration have been suggested. If the interaction between cells and scaffold system with biomolecules can be understood and controlled, and if an optimal 3D tissue regenerating environment is realized, 3D printing technologies will become an important aspect of tissue engineering research in the near future. 3D Printing promises to produce complex biomedical devices according to computer design using patient-specific anatomical data. Since its initial use as pre-surgical visualization models and tooling molds, 3D Printing has slowly evolved to create one-of-a-kind devices, implants, scaffolds for tissue engineering, diagnostic platforms, and drug delivery systems. Fuelled by the recent explosion in public interest and access to affordable printers, there is renewed interest to combine stem cells with custom 3D scaffolds for personalized regenerative medicine. Before 3D Printing can be used routinely for the regeneration of complex tissues (e.g. bone, cartilage, muscles, vessels, nerves in the craniomaxillofacial complex), and complex organs with intricate 3D microarchitecture (e.g. liver, lymphoid organs), several technological limitations must be addressed. Until recently, tablet designs had been restricted to the relatively small number of shapes that are easily achievable using traditional manufacturing methods. As 3D printing capabilities develop further, safety and regulatory concerns are addressed and the cost of the technology falls, contract manufacturers and pharmaceutical companies that experiment with these 3D printing innovations are likely to gain a competitive edge. This review compose the basics, types & techniques used, advantages and disadvantages of 3D printing

scholarly journals On the effect of antiresorptive drugs on the bone remodeling of the mandible after dental implantation: a mathematical model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mehran Ashrafi ◽  
Farzan Ghalichi ◽  
Behnam Mirzakouchaki ◽  
Manuel Doblare
Keyword(s):  
Mathematical Model ◽  
Bone Density ◽  
Bone Remodeling ◽  
Dental Implants ◽  
Implant Design ◽  
Patient Specific ◽  
Dental Implantation ◽  
Antiresorptive Agents ◽  
Antiresorptive Drugs

AbstractBone remodeling identifies the process of permanent bone change with new bone formation and old bone resorption. Understanding this process is essential in many applications, such as optimizing the treatment of diseases like osteoporosis, maintaining bone density in long-term periods of disuse, or assessing the long-term evolution of the bone surrounding prostheses after implantation. A particular case of study is the bone remodeling process after dental implantation. Despite the overall success of this type of implants, the increasing life expectancy in developed countries has boosted the demand for dental implants in patients with osteoporosis. Although several studies demonstrate a high success rate of dental implants in osteoporotic patients, it is also known that the healing time and the failure rate increase, necessitating the adoption of pharmacological measures to improve bone quality in those patients. However, the general efficacy of these antiresorptive drugs for osteoporotic patients is still controversial, requiring more experimental and clinical studies. In this work, we investigate the effect of different doses of several drugs, used nowadays in osteoporotic patients, on the evolution of bone density after dental implantation. With this aim, we use a pharmacokinetic–pharmacodynamic (PK/PD) mathematical model that includes the effect of antiresorptive drugs on the RANK/RANK-L/OPG pathway, as well as the mechano-chemical coupling with external mechanical loads. This mechano-PK/PD model is then used to analyze the evolution of bone in normal and osteoporotic mandibles after dental implantation with different drug dosages. We show that using antiresorptive agents such as bisphosphonates or denosumab increases bone density and the associated mechanical properties, but at the same time, it also increases bone brittleness. We conclude that, despite the many limitations of these very complex models, the one presented here is capable of predicting qualitatively the evolution of some of the main biological and chemical variables associated with the process of bone remodeling in patients receiving drugs for osteoporosis, so it could be used to optimize dental implant design and coating for osteoporotic patients, as well as the drug dosage protocol for patient-specific treatments.

ITVT-07. Robotic alignment module Cirq for navigated brainstem tumor biopsies

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi229-vi229
Author(s):  
Kirsten van Baarsen ◽  
Peter Woerdeman ◽  
Mariam Slot ◽  
Eelco Hoving
Keyword(s):  
Brain Stem ◽  
3D Ct ◽  
Registration Accuracy ◽  
Brainstem Tumor ◽  
Intended Target ◽  
Registration Errors ◽  
Surgical Devices ◽  
Brain Stem Tumors ◽  
Tumor Biopsies ◽  
Euclidian Distances

Abstract BACKGROUND With the incorporation of the robotic alignment module Cirq (Brainlab, Germany) into our neurosurgical armamentarium, we aimed to know our baseline accuracy in stererotactic biopsies. We therefore retrospectively reviewed our data on biopsy accuracy for brain(stem) tumors using the non-robotic alignment instrument Varioguide (Brainlab, Germany). Because of unexpectedly large deviations from the intended target, we sought to improve our registration accuracy when we introduced Cirq. Intraoperative 3D CT with bone fiducials was added to the pre-operative 3D T1 MRI with skin fiducials. This made it possible to compare surgical devices as well as registration methods. AIMS To share our experience with the new robotic alignment module Cirq for navigated brain(stem) tumor biopsies and to evaluate its target accuracy with bone fiducial registration, as compared to the previously used Varioguide with skin fiducial registration. METHODS All patients (0–18 years old) that underwent a brain(stem) biopsy in our institution were included. Over 2018–2020, data were collected retrospectively (cohort Varioguide with 3D T1 MRI registration with skin fiducials). From 2021, data were collected prospectively (cohort Cirq with both 3D T1 MRI registration with skin fiducials and intraoperative CT registration with bone fiducials). For both cohorts, Euclidian distances were calculated between the intended target and the obtained target. For the prospective cohort, registration errors were calculated for bone versus skin fiducials. PRELIMINARY REUSLTS The deviation from the intended target was much smaller in the Cirq cohort versus the Varioguide cohort. Within the Cirq cohort, registration errors were submillimetric for bone fiducial registration as compared to several millimeters for skin fiducial registration. CONCLUSION: The Cirq robotic arm is convenient, safe and highly accurate, especially when combined with intraoperative 3D CT bone fiducial registration. Skin fiducial registration does not offer the level of precision that is mandatory in brainstem tumor biopsies.

scholarly journals Patient-specific instrument-assisted minimally invasive internal fixation of calcaneal fracture for rapid and accurate execution of a preoperative plan: A retrospective study

2020 ◽  
Author(s):  
Chenggong Wang ◽  
Can Xu ◽  
Mingqing Li ◽  
Hui Li ◽  
Han Xiao ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Subtalar Joint ◽  
Calcaneal Fracture ◽  
Patient Specific ◽  
Calcaneal Fractures ◽  
Intraoperative Fluoroscopy ◽  
Joint Width ◽  
Preoperative Plan ◽  
Overlap Ratio ◽  
Minimally Invasive Internal Fixation

Abstract Background: Traditional methods for minimally invasive internal fixation (MIIF) of calcaneal fractures require extensive intraoperative fluoroscopy, and fracture recovery is usually not ideal. We developed a new surgical procedure using digital surgical simulation and constructed a patient-specific instrument (PSI) for calcaneal fracture that we used during the operation. This study investigated whether PSI-assisted MIIF of calcaneal fracture enables rapid and accurate execution of the preoperative plan.Methods: We retrospectively analyzed patients with Sanders type III or IV fresh calcaneal fractures who had undergone PSI-assisted MIIF at our hospital from January 2016 to December 2018. We analyzed perioperative data including intraoperative fluoroscopy time, concurrence of internal fixation actual usage (IFAU) with the preoperative plan, surgery time, and complications. We also compared pre- and postoperative actual measurements from X-ray radiographs and computed tomography images including Böhler, Gissane, and calcaneus valgus angles; subtalar joint width; and calcaneal volume overlap ratio with the preoperative design. All patients had been followed up and their American Orthopedic Foot and Ankle Score (AOFAS) score was available.Results: Mean intraoperative fluoroscopy time was 3.95±1.78 h; IFAU in 16 patients (16 feet) was the same as the preoperative plan; mean surgery time was 28.16±10.70 min; and none of the patients developed complications. Böhler, Gissane, and calcaneus valgus angles and subtalar joint width did not differ between pre- and postoperative plans; however, the actual preoperative values of each of these parameters differed significantly from those measured postoperatively. The calcaneal volume overlap ratio with the preoperative design was 91.2%±2.3%. AOFAS scores increased with time, with significant differences in the score at each time point.Conclusions: The newly developed PSI-assisted calcaneal fracture MIIF method can rapidly and accurately execute the preoperative plan.

Prototyping of Robotic Systems in Surgical Procedures and Automated Manufacturing Processes

2012 ◽  
pp. 356-378
Author(s):  
Zheng (Jeremy) Li
Keyword(s):  
Modeling And Simulation ◽  
System Design ◽  
Surgical Procedures ◽  
Biomedical Engineering ◽  
Robotic System ◽  
Robotic Systems ◽  
Manufacturing Processes ◽  
Automated Manufacturing ◽  
Design Development ◽  
Computer Aided

The prototyping and implementation of robotic system is a scientific and technological integrating of robotic system design, development, testing, and application. This chapter describes the recent development and applications of robotic systems to surgery procedures in biomedical engineering and automated manufacturing processes in industry. It includes the design and development, computer-aided modeling and simulation, prototype analysis, and testing of robotic systems in these two different applications.

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