Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study

计算机辅助导航和增强现实技术在颌骨扩张双皮质微型种植体植入中的应用评价:一项体外研究

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Abstract

The objective of the present study was to evaluate and compare the accuracy of the computer-aided static navigation technique (NAV), augmented reality (AR) and freehand placement technique (FHT) for the bicortical orthodontic self-drilling mini-implants for maxillary skeletal expansion (MSE) appliances placed in palate. Material and Methods: A total of 120 bicortical orthodontic self-drilling mini-implants were placed in the palate of ten 3D printed anatomically based polyurethane models of a completely edentulous upper maxilla. The orthodontic mini-implants were randomly assigned to the following placement techniques: (A) computer-aided static navigation technique (n = 40) (NAV), (B) augmented reality device (n = 40) (AR) and (C) conventional freehand technique (n = 40) (FHT). Moreover, two implants were placed in each side of the midpalatal suture in every model according to the digital planification of the expander device. Subsequently, the orthodontic mini-implants were placed and postoperative CBCT scans were performed. Finally, coronal entry-point (mm), apical end-point (mm) and angular deviations (°) were calculated using a t-test. Results: Statistically significant differences were shown at coronal entry-point (p < 0.001), apical end-point (p < 0.001) and angular deviations (p < 0.001) between the three placement techniques of bicortical orthodontic mini-implants. Additionally, statistically significant differences were also shown between the orthodontic mini-implant positions concerning the entry point (p = 0.004) and angular deviation (p = 0.004). Conclusions: The augmented reality placement technique results are more accurate, followed by the computer-aided static navigation technique and the freehand technique for MSE appliances placed in palate.

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