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The application of virtual reality and augmented reality in Oral & Maxillofacial Surgery
2019
Background
Virtual reality is the science of creating a virtual environment for the assessment of various anatomical regions of the body for the diagnosis, planning and surgical training. Augmented reality is the superimposition of a 3D real environment specific to individual patient onto the surgical filed using semi-transparent glasses to augment the virtual scene.. The aim of this study is to provide an over view of the literature on the application of virtual and augmented reality in oral & maxillofacial surgery.
Methods
We reviewed the literature and the existing database using Ovid MEDLINE search, Cochran Library and PubMed. All the studies in the English literature in the last 10 years, from 2009 to 2019 were included.
Results
We identified 101 articles related the broad application of virtual reality in oral & maxillofacial surgery. These included the following: Eight systematic reviews, 4 expert reviews, 9 case reports, 5 retrospective surveys, 2 historical perspectives, 13 manuscripts on virtual education and training, 5 on haptic technology, 4 on augmented reality, 10 on image fusion, 41 articles on the prediction planning for orthognathic surgery and maxillofacial reconstruction. Dental implantology and orthognathic surgery are the most frequent applications of virtual reality and augmented reality. Virtual planning improved the accuracy of inserting dental implants using either a statistic guidance or dynamic navigation. In orthognathic surgery, prediction planning and intraoperative navigation are the main applications of virtual reality. Virtual reality has been utilised to improve the delivery of education and the quality of training in oral & maxillofacial surgery by creating a virtual environment of the surgical procedure. Haptic feedback provided an additional immersive reality to improve manual dexterity and improve clinical training.
Conclusion
Virtual and augmented reality have contributed to the planning of maxillofacial procedures and surgery training. Few articles highlighted the importance of this technology in improving the quality of patients’ care. There are limited prospective randomized studies comparing the impact of virtual reality with the standard methods in delivering oral surgery education.
Journal Article
Research on the application of CBL combined with BOPPPS teaching mode in oral and maxillofacial surgery teaching: a randomized controlled study
by
Gao, Ning
,
Li, Na
,
He, Wei
in
692/700/3032/3053
,
692/700/3032/3053/3054
,
692/700/3032/3053/3055
2024
To discuss the application value of Case-based Learning (CBL) combined with Bridge-In, Objective, Pre-assessment, Participatory Learning, Post-assessment, and Summary (BOPPPS) model into master students’ program of oral and maxillofacial surgery. 38 master’s students in oral and maxillofacial surgery at Y2 and Y3 from January 2022 to December 2022 are selected as the research objects. They are randomly assigned into two learning groups, namely the traditional LBL (Learn-based Learning) (19 participants) and CBL combined with BOPPPS mode (19 participants). Their theoretical knowledge was assessed after training and the modified Mini-Clinical Evaluation Exercise (Mini-CEX) scale was used to score their clinical thinking. At the same time, the Personal Teaching Efficiency and the Teachers’ Sense of Teaching Efficiency (TSTE) were evaluated, and students’ satisfaction with teaching outcomes was investigated. The basic theoretical knowledge, clinical case analysis and total scores of the experimental group were better than those of the control group, with statistically significant difference (
P
<0.05). Based on the evaluation of clinical speculative thinking by the modified Mini-CEX, it is found that except for the medical history writing level without statistically significant difference (
P
>0.05), the other four items and total scores in the experimental group were better than those in the control group, with statistically significant difference (
P
<0.05).The Personal Teaching Efficiency, TSTE and total scores were higher than those before adopting CBL combined with BOPPPS teaching mode, with statistically significant difference (
P
<0.05).The sampled master’s students in experimental group believed that the new teaching method could improve students’ ability to clinical speculative thinking, with statistically significant difference in all aspects (
P
<0.05).More participants in the experimental group suggested that the new teaching mode has increased learning pressure, but without statistically significant difference (
P
>0.05). CBL combined with BOPPPS teaching method can improve students’ clinical critical thinking ability and help them adapt to the clinical rhythm. It is an effective measure to ensure teaching quality and is worthy of promotion. It is worthwhile to promote the application of CBL combined with BOPPPS mode into master’s course of oral and maxillofacial surgery, which not only improve the basic theoretical knowledge and speculative thinking ability of master’s students, but also improve the teaching efficiency.
Journal Article
Comparison of the long-term clinical performance of a biodegradable and a titanium fixation system in maxillofacial surgery: A multicenter randomized controlled trial
by
Buijs, G. J.
,
Bos, R. R. M.
,
de Visscher, J. G. A. M.
in
Absorbable implants
,
Adolescent
,
Adult
2017
Biodegradable fixation systems could reduce or eliminate problems associated with titanium removal of implants in a second operation.
The aim of this study was to compare the long-term (i.e. >5 years postoperatively) clinical performance of a titanium and a biodegradable system in oral and maxillofacial surgery.
The present multicenter Randomized Controlled Trial (RCT) was performed in four hospitals in the Netherlands. Patients treated with a bilateral sagittal split osteotomy (BSSO) and/or a Le Fort-I osteotomy, and those treated for fractures of the mandible, maxilla, or zygoma were included from December 2006 to July 2009. The patients were randomly assigned to either a titanium (KLS Martin) or a biodegradable group (Inion CPS).
After >5 years postoperatively, plate removal was performed in 22 of the 134 (16.4%) patients treated with titanium and in 23 of the 87 (26.4%) patients treated with the biodegradable system (P = 0.036, hazard ratio (HR) biodegradable (95% CI) = 2.0 (1.05-3.8), HR titanium = 1). Occlusion, VAS pain scores, and MFIQ showed good and (almost) pain free mandibular function in both groups.
In conclusion, the performance of the Inion CPS biodegradable system was inferior compared to the KLS Martin titanium system regarding plate/screws removal in the abovementioned surgical procedures.
http://controlled-trials.com ISRCTN44212338.
Journal Article
Oral Cancer: A Historical Review
by
Inchingolo, Francesco
,
Topi, Skender
,
Charitos, Ioannis Alexandros
in
Digital archives
,
Egyptian civilization
,
Medical diagnosis
2020
Aim: This historical medical literature review aims at understanding the evolution of the medical existence of oral cancer over times, particularly better comprehending if the apparent lower prevalence of this type of cancer in antiquity is a real value due to the absence of modern environmental and lifestyle factors or it is linked to a misinterpretation of ancient foreign terms found in ancient medical texts regarding oral neoplasms. Methods: The databases MedLne, PubMed, Web of Science, Elsevier’s EMBASE.com, Cochrane Review, National Library of Greece (Stavros Niarchos Foundation, Athens) and the Library of the School of Health Sciences of the National and Kapodistrian University of Athens (Greece) were extensively searched for relevant studies published during the past century on the history of oral cancer and its treatment from antiquity to modern times, in addition to the WHO website to analyse the latest epidemiological data. In addition, we included historical books on the topic of interest and original sources. Results: Historical references reveal that the cradle of the oral oncology was in ancient Egypt, the Asian continent and Greece and cancer management was confined to an approximate surgical practice, in order to remove abnormal masses and avoid bleeding with cauterization. In the Medieval Age, little progress occurred in medicine in general, oral cancers management included. It is only from the Renaissance to modern times that knowledge about its pathophysiological mechanisms and histopathology and its surgical and pharmacological treatment approaches became increasingly deep all over the world, evolving to the actual integrated treatment. Despite the abundant literature exploring oncology in past civilizations, the real prevalence of oral cancer in antiquity is much less known; but a literature analysis cannot exclude a consistent prevalence of this cancer in past populations, probably with a likely lower incidence than today, because many descriptions of its aggressiveness were found in ancient medical texts, but it is still difficult to be sure that each single description of oral masses could be associated to cancer, particularly for what concerns the period before the Middle Ages. Conclusions: Modern oncologists and oral surgeons must learn a lot from their historic counterparts in order to avoid past unsuccessful efforts to treatment oral malignancies. Several descriptions of oral cancers in the antiquity that we found let us think that this disease might be linked to mechanisms not strictly dependent on environmental risk factors, and this might guide future research on oral cavity treatments towards strategical cellular and molecular techniques.
Journal Article
Artificial intelligence-based chatbot assistance in clinical decision-making for medically complex patients in oral surgery: a comparative study
2025
Aim
This study aims to evaluate the potential of AI-based chatbots in assisting with clinical decision-making in the management of medically complex patients in oral surgery.
Materials and methods
A team of oral and maxillofacial surgeons developed a pool of open-ended questions
de novo
. The validity of the questions was assessed using Lawshe’s Content Validity Index. The questions, which focused on systemic diseases and common conditions that may raise concerns during oral surgery, were presented to ChatGPT 3.5 and Claude-instant in two separate sessions, spaced one week apart. Two experienced maxillofacial surgeons, blinded to the chatbots, assessed the responses for quality, accuracy, and completeness using a modified DISCERN tool and Likert scale. Intraclass correlation, Mann-Whitney U test, skewness, and kurtosis coefficients were employed to compare the performances of the chatbots.
Results
Most responses were high quality: 86% and 79.6% for ChatGPT, and 81.25% and 89% for Claude-instant in sessions 1 and 2, respectively. In terms of accuracy, ChatGPT had 92% and 93.4% of its responses rated as completely correct in sessions 1 and 2, respectively, while Claude-instant had 95.2% and 89%. For completeness, ChatGPT had 88.5% and 86.8% of its responses rated as adequate or comprehensive in sessions 1 and 2, respectively, while Claude-instant had 95.2% and 86%.
Conclusion
Ongoing software developments and the increasing acceptance of chatbots among healthcare professionals hold promise that these tools can provide rapid solutions to the high demand for medical care, ease professionals’ workload, reduce costs, and save time.
Journal Article
Application of dynamic navigation technology in oral and maxillofacial surgery
by
Sun, Wei
,
Cai, Xinjie
,
Meng, Liuyan
in
Computed tomography
,
Cone-Beam Computed Tomography
,
Dental caries
2024
Objectives
Dynamic navigation (DN) technology has ushered in a paradigm shift in dentistry, revolutionizing the precision of diverse procedures in oral and craniofacial surgery. This comprehensive review aims to review the manifold applications of DN, including implantology, endodontics, oral and dental surgeries, and other dental disciplines.
Materials and methods
A thorough search of the online databases PubMed and Google Scholar was conducted up to March 2024. Publications associated with DN in the field of oral and maxillofacial surgery were sourced.
Results
Narrative literature review.
Conclusions
DN harnesses cone beam computerized tomography imaging, virtual design software, and motion tracking technology to construct a virtual model of the patient’s oral cavity, affording real-time instrument tracking during procedures. Notably, in implantology, DN facilitates implant placement, enhances safety measures, and augments procedural efficiency. The application of DN in sinus lift procedures contributes to improved surgical outcomes and reduced complications. Within endodontics, DN guides root canal treatment (RCT), retreatment of failed RCT, and endodontic microsurgery, ensuring conservative access cavities and precise canal location. Beyond these, the versatility of DN extends to encompass maxillomandibular and orthognathic surgeries, tooth extraction, removal of foreign bodies, and facial reconstruction. However, it is crucial to acknowledge potential disadvantages and error-prone scenarios as DN technologies advance.
Clinical significance
DN technology empowers dentists with high accuracy, heightened safety protocols, and increased procedural efficiency, culminating in enhanced patient outcomes across various dental procedures. As DN technology further expands, its pivotal role will advance in the future of oral and maxillofacial surgery.
Journal Article
The current landscape of artificial intelligence in oral and maxillofacial surgery– a narrative review
by
Abbadi, Sam El
,
Brar, Branden R.
,
Chigurupati, Radhika
in
Artificial Intelligence
,
Clinical outcomes
,
Humans
2025
Objective
This narrative review aims to explore the current applications and future prospects of AI within the subfields of oral and maxillofacial surgery (OMS), emphasizing its potential benefits and anticipated challenges.
Methods
A detailed review of the literature was conducted to evaluate the role of AI in oral and maxillofacial surgery. All domains within OMS were reviewed with a focus on diagnostic, therapeutic and prognostic interventions.
Results
AI has been successfully integrated into surgical specialties to enhance clinical outcomes. In OMS, AI demonstrates potential to improve clinical and administrative workflows in both ambulatory and hospital-based settings. Notable applications include more accurate risk prediction, minimally invasive surgical techniques, and optimized postoperative management.
Conclusion
OMS stands to benefit enormously from the integration of AI. However, significant roadblocks, such as ethical concerns, data security, and integration challenges, must be addressed to ensure effective adoption. Further research and innovation are needed to fully realize the potential of AI in this specialty.
Journal Article
Augmented reality for dental implantology: a pilot clinical report of two cases
by
Ferri, Agnese
,
Marchetti, Claudio
,
Mangano, Carlo
in
Augmented reality
,
Case Report
,
Computer-assisted surgery
2019
Background
Despite the limited number of articles dedicated to its use, augmented reality (AR) is an emerging technology that has shown to have increasing applications in multiple different medical sectors. These include, but are not limited to, the Maxillo-facial and Dentistry disciplines of medicine. In these medical specialties, the focus of AR technology is to achieve a more visible surgical field during an operation. Currently, this goal is brought about by an accurate display of either static or dynamic diagnostic images via the use of a visor or specific glasses.
The objective of this study is to evaluate the feasibility of using a virtual display for dynamic navigation via AR. The secondary outcome is to evaluate if the use of this technology could affect the accuracy of dynamic navigation.
Case presentation
Two patients, both needing implant rehabilitation in the upper premolar area, were treated with flapless surgery. Prior to the procedure itself, the position of the implant was virtually planned and placed for each of the patients using their previous scans. This placement preparation contributed to a dynamic navigation system that was displayed on AR glasses. This, in turn, allowed for the use of a computer-aided/image-guided procedure to occur. Dedicated software for surface superimposition was then used to match the planned position of the implant and the real one obtained from the postoperative scan. Accuracies, using this procedure were evaluated by way of measuring the deviation between real and planned positions of the implants. For both surgeries it was possible to proceed using the AR technology as planned. The deviations for the first implant were 0.53 mm at the entry point and 0.50 mm at the apical point and for the second implant were 0.46 mm at the entry point and 0.48 mm at the apical point. The angular deviations were respectively 3.05° and 2.19°.
Conclusions
From the results of this pilot study, it seems that AR can be useful in dental implantology for displaying dynamic navigation systems. While this technology did not seem to noticeably affect the accuracy of the procedure, specific software applications should further optimize the results.
Journal Article
Automated cephalometric landmark detection with confidence regions using Bayesian convolutional neural networks
2020
Background
Despite the integral role of cephalometric analysis in orthodontics, there have been limitations regarding the reliability, accuracy, etc. of cephalometric landmarks tracing. Attempts on developing automatic plotting systems have continuously been made but they are insufficient for clinical applications due to low reliability of specific landmarks. In this study, we aimed to develop a novel framework for locating cephalometric landmarks with confidence regions using Bayesian Convolutional Neural Networks (BCNN).
Methods
We have trained our model with the dataset from the ISBI 2015 grand challenge in dental X-ray image analysis. The overall algorithm consisted of a region of interest (ROI) extraction of landmarks and landmarks estimation considering uncertainty. Prediction data produced from the Bayesian model has been dealt with post-processing methods with respect to pixel probabilities and uncertainties.
Results
Our framework showed a mean landmark error (LE) of 1.53 ± 1.74 mm and achieved a successful detection rate (SDR) of 82.11, 92.28 and 95.95%, respectively, in the 2, 3, and 4 mm range. Especially, the most erroneous point in preceding studies, Gonion, reduced nearly halves of its error compared to the others. Additionally, our results demonstrated significantly higher performance in identifying anatomical abnormalities. By providing confidence regions (95%) that consider uncertainty, our framework can provide clinical convenience and contribute to making better decisions.
Conclusion
Our framework provides cephalometric landmarks and their confidence regions, which could be used as a computer-aided diagnosis tool and education.
Journal Article
Is there a common pattern of dental specialties in the world? Orthodontics, the constant element
by
Fernández-Serrano, Javier
,
Garcia-Espona, Eugenia
,
Garcia-Espona, Cristina
in
Analysis
,
Cluster Analysis
,
Dental Care
2024
Background
There is a lack of studies comparing the status of dental specialties worldwide. Therefore, this study aimed to analyze the differences and similarities between the number and types of dental specialties in 31 countries, including every continent, in the world.
Materials and methods
Available official documents and webpages from regulatory bodies, official colleges and councils, and dental institutions were collected from 31 countries and analyzed to obtain reliable data on dental specialties. Differences were analyzed using the Lorentz curve and Gini test. Additionally, a cluster analysis was performed to obtain groups of countries with similar patterns in the number and types of dental specialties.
Results
A total of 32 different specialties were officially recognized among all the analyzed countries. Orthodontics and oral surgery (100% and 93.1%, respectively) were the two most frequently officially recognized dental specialties worldwide. The total global degree of inequality in the 31 analyzed countries was 42.4%. The Anglo-Saxon countries showed the greatest similarity, approximately 15-fold higher than the European countries. Cluster analysis differentiated six main groups of countries according to the number and types of dental specialties. European countries formed one of the two largest clusters, and the other cluster was of Anglo-Saxon, Asian, African, and several Eastern European countries with a high number of specialties.
Conclusions
Officially recognized dental specialties in the different continents and countries show an asymmetric organization. The number, names, and skills of officially recognized dental specialties exhibited significant differences, showing inequalities in their organization. The Anglo-Saxon pattern of dental specialties showed greater equality than the European pattern. Orthodontics was the only constant element among the different patterns.
Journal Article