[Show abstract][Hide abstract] ABSTRACT: Ever since the development of the first applications in image-guided therapy (IGT), the use of head-mounted displays (HMDs) was considered an important extension of existing IGT technologies. Several approaches to utilizing HMDs and modified medical devices for augmented reality (AR) visualization were implemented. These approaches include video-see through systems, semitransparent mirrors, modified endoscopes, and modified operating microscopes. Common to all these devices is the fact that a precise calibration between the display and three-dimensional coordinates in the patient's frame of reference is compulsory. In optical see-through devices based on complex optical systems such as operating microscopes or operating binoculars-as in the case of the system presented in this paper-this procedure can become increasingly difficult since precise camera calibration for every focus and zoom position is required. We present a method for fully automatic calibration of the operating binocular Varioscope M5 AR for the full range of zoom and focus settings available. Our method uses a special calibration pattern, a linear guide driven by a stepping motor, and special calibration software. The overlay error in the calibration plane was found to be 0.14-0.91 mm, which is less than 1% of the field of view. Using the motorized calibration rig as presented in the paper, we were also able to assess the dynamic latency when viewing augmentation graphics on a mobile target; spatial displacement due to latency was found to be in the range of 1.1-2.8 mm maximum, the disparity between the true object and its computed overlay represented latency of 0.1 s. We conclude that the automatic calibration method presented in this paper is sufficient in terms of accuracy and time requirements for standard uses of optical see-through systems in a clinical environment.
Full-text · Article · Dec 2005 · IEEE Transactions on Medical Imaging
[Show abstract][Hide abstract] ABSTRACT: To determine the real emitted output power and maximum surface heating of commercial therapeutic ultrasound transducers emitting in air for various therapeutic regimens.
Surface temperatures of ultrasound transducers with frequencies of .05 to 3 MHz were detected over 5 minutes by using a calibrated infrared thermographic camera; additionally, the indicated output power was checked with a radiation force balance.
University center for biomedical engineering and physics and medical school for physical medicine and rehabilitation.
Power variations and surface temperatures of clinical devices were analyzed to determine whether they comply with obligatory limits given in International Electrotechnical Commission standard 60601-2-5.
Depending on the operation mode and the output power, surface temperatures ranged between 24.2 degrees to 80 degrees C within 5 minutes. Differences between measured and displayed power output (limit, +/-20%) ranged between -32% and 28%.
The effectiveness of treatment is lowered if the value of emitted power is not known reliably. In the worst case, damage or irritation of the skin is possible, particularly in patients with sensory compromised skin. Damage may be caused by hot surfaces if the threshold level required to activate the device is lowered or if the device is defective. Improved thermal control units are necessary to prevent potential thermal hazards. Regular checks of transducer emission should be obligatory to ensure correct and precise function of the clinical devices.
No preview · Article · Aug 2005 · Archives of Physical Medicine and Rehabilitation
[Show abstract][Hide abstract] ABSTRACT: This paper defines a simple protocol for competitive and quantified evaluation of electromagnetic tracking systems such as the NDI Aurora (A) and Ascension microBIRD with dipole transmitter (B). It establishes new methods and a new phantom design which assesses the reproducibility and allows comparability with different tracking systems in a consistent environment. A machined base plate was designed and manufactured in which a 50 mm grid of holes was precisely drilled for position measurements. In the center a circle of 32 equispaced holes enables the accurate measurement of rotation. The sensors can be clamped in a small mount which fits into pairs of grid holes on the base plate. Relative positional/orientational errors are found by subtracting the known distances/ rotations between the machined locations from the differences of the mean observed positions/ rotation. To measure the influence of metallic objects we inserted rods made of steel (SST 303, SST 416), aluminum, and bronze into the sensitive volume between sensor and emitter. We calculated the fiducial registration error and fiducial location error with a standard stylus calibration for both tracking systems and assessed two different methods of stylus calibration. The positional jitter amounted to 0.14 mm(A) and 0.08 mm(B). A relative positional error of 0.96 mm +/- 0.68 mm, range -0.06 mm; 2.23 mm(A) and 1.14 mm +/- 0.78 mm, range -3.72 mm; 1.57 mm(B) for a given distance of 50 mm was found. The relative rotation error was found to be 0.51 degrees (A)/0.04 degrees (B). The most relevant distortion caused by metallic objects results from SST 416. The maximum error 4.2 mm(A)/ > or = 100 mm(B) occurs when the rod is close to the sensor(20 mm). While (B) is more sensitive with respect to metallic objects, (A) is less accurate concerning orientation measurements. (B) showed a systematic error when distances are calculated.
[Show abstract][Hide abstract] ABSTRACT: 3D/2D registration, the automatic assignment of a global rigid-body transformation matching the coordinate systems of patient and preoperative volume scan using projection images, is an important topic in image-guided therapy and radiation oncology. A crucial part of most 3D/2D registration algorithms is the fast computation of digitally rendered radiographs (DRRs) to be compared iteratively to radiographs or portal images. Since registration is an iterative process, fast generation of DRRs-which are perspective summed voxel renderings-is desired. In this note, we present a simple and rapid method for generation of DRRs based on splat rendering. As opposed to conventional splatting, antialiasing of the resulting images is not achieved by means of computing a discrete point spread function (a so-called footprint), but by stochastic distortion of either the voxel positions in the volume scan or by the simulation of a focal spot of the x-ray tube with non-zero diameter. Our method generates slightly blurred DRRs suitable for registration purposes at framerates of approximately 10 Hz when rendering volume images with a size of 30 MB.
No preview · Article · Jun 2005 · Physics in Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: This study aims at a comparative evaluation of two recently introduced electromagnetic tracking systems under reproducible simulated operating-room (OR) conditions: the recently launched Medtronic StealthStation, Treon-EM and the NDI Aurora. We investigate if and to what extent these systems provide improved performance and stability in the presence of surgical instruments as possible sources of distortions compared with earlier reports on electromagnetic tracking technology. To investigate possible distortions under pseudo-realistic OR conditions, a large Langenbeck hook, a dental drill with its handle and an ultrasonic (US) scanhead are fixed on a special measurement rack at variable distances from the navigation sensor. The position measurements made by the Treon-EM were least affected by the presence of the instruments. The lengths of the mean deviation vectors were 0.21 mm for the Langenbeck hook, 0.23 mm for the drill with handle and 0.56 mm for the US scanhead. The Aurora was influenced by the three sources of distortion to a higher degree. A mean deviation vector of 1.44 mm length was observed in the vicinity of the Langenbeck hook, 0.53 mm length with the drill and 2.37 mm due to the US scanhead. The maximum of the root mean squared error (RMSE) for all coordinates in the presence of the Langenbeck hook was 0.3 mm for the Treon and 2.1 mm for the Aurora; the drill caused a maximum RMSE of 0.2 mm with the Treon and 1.2 mm with the Aurora. In the presence of the US scanhead, the maximum RMSE was 1.4 mm for the Treon and 5.1 mm for the Aurora. The new generation of electromagnetic tracking systems has significantly improved compared to common systems that were available in the middle of the 1990s and has reached a high level of technical development. We conclude that, in general, both systems are suitable for routine clinical application.
Full-text · Article · Jun 2005 · Physics in Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: An inter-laboratory comparison study was conducted to assess the image quality of PET scanners in Austria. The survey included both dedicated PET scanners (D-PET, n = 8) and coincidence cameras (GC-PET, n = 7). Measurement of image quality was based on the NEMA (National Electrical Manufacturers Association) NU 2-2001 protocol and the IEC (International Electrotechnical Commission) body phantom. The latter contains six fillable spheres ranging in diameter from 37 mm down to 10 mm and a 'lung' insert. The two largest lesions L1-2 simulate cold lesions, the four smaller ones (L3-6) are filled with 18F and activity concentration ratios relative to background of 8:1 and 4:1, respectively. Acquisition and reconstruction in the study employed the participating institutes' standard oncological processing protocol. Calculation of contrast of the spheres was performed with a fully automated procedure. Contrast quality indices (CQIs) reflecting global performance were obtained by summing individual contrast values. Other image quality parameters calculated according to the NEMA protocol were background variability and relative error for correction of attenuation and scatter. Contrast values obtained were 61 +/- 16 and 37 +/- 14 for L1 (per cent contrast +/- SD for D-PET and GC-PET, respectively), 57 +/- 16 and 29 +/- 16 for L2, 46 +/- 10 and 26 +/- 6.3 for L3, 37 +/- 10 and 15 +/- 4.3 for L4, 26 +/- 11.5 and 6.1 +/- 2.5 for L5, 14 +/- 7.1 and 2.6 +/- 2.6 for L6, with D-PET systems consistently being superior to GC-PET systems. CQIs permitted ranking of the scanners, also demonstrating a clear distinction between D-PET and GC-PET systems. Background variability was largest for GC-PET systems; the relative error of attenuation and scatter correction was significantly correlated with image quality for D-PET systems only. The study demonstrated considerable differences in image quality not only between GC-PET and D-PET systems but also between individual D-PET systems with possible consequences for clinical interpretation of images and measurement of quantitative indices such as the standardized uptake value. The study provided valuable feedback to the participants as well as baseline data for improving interchangeability of PET images and of quantitative indices between different laboratories.
No preview · Article · Jun 2005 · Physics in Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: We sought to develop a robotic system for computed tomography (CT)-guided biopsy to validate the feasibility, accuracy, and efficacy of the system using phantom tests.
Ten peas (mean diameter 9.9+/-0.4 mm) embedded within a gel phantom were selected for biopsy. Once the best access was defined on CT images, the position of the phantom was recorded by an optical tracking system. Positional data about the phantom and the corresponding CT image was transferred to the robot planning system (Linux-based industrial PC equipped with video capture card). Once the appropriate position, angulation, and pitch were calculated, the robotic arm moved automatically with 7 degrees-of-freedom to the planned insertion path, aiming the needle-trajectory at the center of the target. Then, the biopsy was performed manually using a coaxial technique. The length of all harvested specimens was measured and short cut pieces of a guidewire were pushed into the target to evaluate the deviation of the actual needle track from the target.
In all targets, biopsy specimens (mean length 5.6+/-1.4 mm) were harvested with only 1 needle pass required. The mean deviation of the needle tip from the center of the target in the x and z axes was 1.2+/-0.9 mm and 0.6+/-0.4 mm, respectively.
Robotic-assisted biopsies in vitro, using CT guidance, were feasible and provided high accuracy.
Full-text · Article · May 2005 · Investigative Radiology
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to develop a robotic system for ultrasound (US)-guided biopsy and to validate the feasibility, accuracy and efficacy using phantom tests. Twenty peas (mean diameter 9.3+/-0.1 mm) embedded within a gel-phantom were selected for biopsy. Once the best access was defined, the position of the US transducer was recorded by an optical tracking system. Positional data of the transducer and the corresponding US image were transferred to the roboter planning system (LINUX-based industrial PC equipped with video capture card). Once the appropriate position, angulation and pitch were calculated, the robotic arm moved automatically with seven degrees-of-freedom to the planned insertion path, aiming the needle-positioning unit at the center of the target. Then, the biopsy was performed manually using a coaxial technique. The length of all harvested specimens was measured, and the deviation of the actual needle tract from the center of the target was evaluated sonographically. In all targets, the biopsy specimen (mean length 5+/-1.2 mm) was harvested with only one needle pass required The mean deviation of the needle tip from the center of the target was 1.1+/-0.8 mm. Robotic assisted biopsies in-vitro using US-guidance were feasible and provided high accuracy.
Full-text · Article · May 2005 · European Radiology
[Show abstract][Hide abstract] ABSTRACT: In the last years we developed and tested a head mounted display (HMD) for augmented reality applications in computer aided surgery. This HMD was developed by adapting the Varioscope AF3 (Life Optics, Vienna), an operating binocular with variable zoom and focus. One of the drawbacks of the AF3 was the missing possibility to set the zoom and focus values automatically via a machine usable interface, necessary for automatic calibration of the device. The paper presents the successor of the Varioscope AF3, the Varioscope M5 adapted for augmented reality by our lab. This device has an interface for machine controlled setting of the zoom and focus lens groups via RS 232. This enabled us to develop an automated calibration using a calibration grid mounted on a linear positioner. The position of the grid was controlled using a stepping motor controller connected via IEEE 488. The calibration grid was equipped with automatically detectable fiducial points using varying cross values of consecutive points. The resulting point pairs were used for a camera calibration with Tsai's algorithm. Tracker probes (Traxtal, Toronto) were mounted on the HMD and onto the calibration grid to derive the transformation from the coordinate system of the HMD into the system of the displays. The error of this calibrations was measured comparing the position of the tip of a bayonet probe calculated by the algorithm and found in the image of a camera mounted at the eyepiece of the device. Averaging 16 positions of the probe this deviation was found to be 0.97 +/- 0.22 mm.
No preview · Article · Apr 2005 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: The major aim of this work was to define a protocol for evaluation of electromagnetic tracking systems (EMTS). Using this protocol we compared two commercial EMTS: the Ascension microBIRD (B) and NDI Aurora (A). To enable reproducibility and comparability of the assessments a machined base plate was designed, in which a 50 mm grid of holes is precision drilled for position measurements. A circle of 32 equispaced holes in the center enables the assessment of rotation. A small mount which fits into pairs of grid holes on the base plate is used to mount the sensor in a defined and rigid way. Relative positional/orientational errors are found by subtracting the known distances/rotations between the machined locations from the differences of the mean observed positions/rotation. To measure the influence of metallic objects we inserted rods (made of SST 303, SST 416, aluminum, and bronze) into the sensitive volume between sensor and emitter. Additionally the dynamic behavior was tested by using an optical sensor mounted on a spacer in a distance of 150 mm to the EMTS sensors. We found a relative positional error of 0.96mm +/- 0.68mm, range -0.06mm;2.23mm (A) and 1.14mm +/- 0.78mm, range -3.72mm;1.57mm (B) for a give distance of 50 mm. The positional jitter amounted to 0.14 mm(A) / 0.20mm (B). The relative rotation error was found to be 1.81 degrees(A) / 0.63 degrees(B). For the dynamic behavior we calculated an error of 1.63mm(A)/1.93mm(B). The most relevant distortion caused by metallic objects results from SST 416. The maximum error 4.2mm(A)/41.9mm(B) occurs when the rod is close to the sensor(20mm).
No preview · Article · Apr 2005 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: We present a simple and rapid method for generation of perspective digitally rendered radiographs (DRR) for 2D/3D registration
based on splat rendering. Suppression of discretization artefacts by means of computation of Gaussian footprints – which is
a considerable computational burden in classical splat rendering – is replaced by stochastic motion of either the voxels in
the volume to be rendered, or by simulation of a X-ray tube focal spot of finite size. The result is a simple and fast perspective
rendering algorithm using only a small subset of voxels. Our method generates slightly blurred DRRs suitable for registration
purposes at framerates of approximately 10 Hz when rendering volume images with a size of 30 MB on a standard PC.
[Show abstract][Hide abstract] ABSTRACT: Due to converting losses the probe's surface itself is heated up, especially when emitting into air. Possible temperature increases in an ensemble of 15 different diagnostic and therapeutic ultrasound probes from 7 manufacturers in the frequency range between 0.05–7.5 MHz have been examined. Surface temperatures were detected by means of a calibrated IR-thermographic camera using a scheme of various power and pulse settings, as well as different imaging modalitites as used in clinical routine. Depending on the setup and the output power, the absolute surface temperatures of some of the probes emitting in air can be beyond 43 °C within 5–7 min.; a maximum surface temperature of 84 °C has been detected. Continuous mode or high pulse repetition frequencies on the therapeutic system side, small focused Doppler modes on the diagnostic system side combined with increased emitted acoustic intensities result in high surface temperatures. Within a worst case scenario a potential risk of negative skin changes (heat damage) or non-optimal therapeutic effects seems to be possible if a therapeutic system is used very often and if its emission continues unintentionally. In general the user should be aware that low emission intensities of e.g. 50 mW cm-2 could already produce hot surfaces.
No preview · Article · Aug 2004 · Journal of Physics Conference Series
[Show abstract][Hide abstract] ABSTRACT: With the miniaturization of electromagnetic tracking systems (EMTS) the range of possible applications in image guided therapy was extending. A diameter smaller than 1 mm allows for mounting these sensors into the working channel of flexible endoscopes for navigation within the body. Knowing the exact position of the instrument with respect to the patient"s position preoperative CT or MR images can simplify and ease navigation during various interventions. The Aurora EMTS seems to be an ideal choice for this purpose. However, using this system exhibits an important limitation: the sensor offers just 5 degrees of freedom (DOF) which means that rotations round the axis of the sensor cannot be measured. To overcome this restriction we used an additional optical tracking system (OTS) which is calibrated to deliver the missing DOF. To evaluate the suitability of our new navigation system we measured the Fiducial Registration Error (FRE) of the diverse registrations and the Target Registration Error (TRE) for the complete transformation from the US space to the CT space. The FRE for the ultrasound calibration amounted to 3.2 mm+/-2.2 mm, resulting from 10 calibration procedures. For the transformation from the OTS reference system to the EMTS emitter space we found an average FRE of 0.8 mm+/-0.2 mm. The FRE for the CT registration was 1.0 mm+/-0.3 mm. The TRE was found to be 5.5 mm+/- 3.2 mm.
No preview · Article · May 2004 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: We are developing an optical see through head mounted display in which preoperative planning data provided by a computer aided surgery system is overlaid to the optical image of the patient. In order to cope with head movements of the surgeon the device has to be calibrated for a wide zoom and focus range. For such a calibration accurate and robust localization of a huge amount of calibration points is of utmost importance. Because of the negligible radial distortion of the optics in our device, we were able to use projective invariants for stable detection of the calibration fiducials on a planar grid. The pattern at the planar grid was designed using a different cross ratio for four consecutive points in x respectively y direction. For automated image processing we put a CCD camera behind the eye piece of the device. The resulting image was thresholded and segmented, after deleting the artefacts a Sobel edge detector was applied and the image was Hough transformed to detect the x and y axes. Then the world coordinates of fiducial points on the grid could be detected. A series of six camera calibrations with two zoom settings was done. The mean values of the errors for the two calibrations were 0.08 mm respectively 0.3 mm.
Full-text · Article · May 2004 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to evaluate the feasibility and accuracy of a novel surgical computer-aided navigation system for the placement of endosseous implants in patients after ablative tumour surgery. Pre-operative planning was performed by developing a prosthetic concept and modifying the implant position according to surgical requirements after high-resolution computed tomography (HRCT) scans with VISIT, a surgical planning and navigation software developed at the Vienna General Hospital. The pre-operative plan was transferred to the patients intraoperatively using surgical navigation software and optical tracking technology. The patients were HRCT-scanned again to compare the position of the implants with the pre-operative plan on reformatted CT-slices after matching of the pre- and post-operative data sets using the mutual information-technique. A total of 32 implants was evaluated. The mean deviation was 1.1 mm (range: 0-3.5 mm). The mean angular deviation of the implants was 6.4 degrees (range: 0.4 degrees - 17.4 degrees, variance: 13.3 degrees ). The results demonstrate, that adequate accuracy in placing endosseous oral implants can be delivered to patients with most difficult implantologic situations.
No preview · Article · Jul 2003 · Clinical Oral Implants Research
[Show abstract][Hide abstract] ABSTRACT: Previous studies in diabetic patients suggested a relationship between delayed gastric emptying and increased ingesta retention in either proximal or distal stomach, but the determinants underlying these abnormalities remained obscure. We aimed at assessing the impact of cardiovascular autonomic neuropathy, blood glucose concentration, long-term glycemic control, and other factors in 34 type I and 43 type II diabetic patients (ages 21-67 and 34-81 years, respectively). Emptying was slower (P < 0.04) in type I diabetic patients than in 20 healthy control subjects (ages 23-63 years). Patients with autonomic neuropathy (N = 45) had slower gastric emptying (P < 0.02) and retained more in the distal stomach (P < 0.0001) than patients without neuropathy (N = 32). Multiple regression analyses revealed that slow emptying and increased distal retention were significantly associated with autonomic neuropathy (P < 0.043, P < 0.0002), whereas blood glucose, glycemic control, diabetes duration, age, and other factors had no discernible influence. Thus, both slow emptying and increased distal ingesta retention seem primarily referable to autonomic neuropathy.
No preview · Article · Jun 2003 · Digestive Diseases and Sciences
[Show abstract][Hide abstract] ABSTRACT: Based on the Varioscope, a commercially available head-mounted operating binocular, we have developed the Varioscope AR, a see through head-mounted display (HMD) for augmented reality visualization that seamlessly fits into the infrastructure of a surgical navigation system. We have assessed the extent to which stereoscopic visualization improves target localization in computer-aided surgery in a phantom study. In order to quantify the depth perception of a user aiming at a given target, we have designed a phantom simulating typical clinical situations in skull base surgery. Sixteen steel spheres were fixed at the base of a bony skull, and several typical craniotomies were applied. After having taken CT scans, the skull was filled with opaque jelly in order to simulate brain tissue. The positions of the spheres were registered using VISIT, a system for computer-aided surgical navigation. Then attempts were made to locate the steel spheres with a bayonet probe through the craniotomies using VISIT and the Varioscope AR as a stereoscopic display device. Localization of targets 4 mm in diameter using stereoscopic vision and additional visual cues indicating target proximity had a success rate (defined as a first-trial hit rate) of 87.5%. Using monoscopic vision and target proximity indication, the success rate was found to be 66.6%. Omission of visual hints on reaching a target yielded a success rate of 79.2% in the stereo case and 56.25% with monoscopic vision. Time requirements for localizing all 16 targets ranged from 7.5 min (stereo, with proximity cues) to 10 min (mono, without proximity cues). Navigation error is primarily governed by the accuracy of registration in the navigation system, whereas the HMD does not appear to influence localization significantly. We conclude that stereo vision is a valuable tool in augmented reality guided interventions.
No preview · Article · Mar 2003 · Physics in Medicine and Biology
[Show abstract][Hide abstract] ABSTRACT: During the last few years head mounted displays (HMD) became an more important display device in computer assisted surgery (CAS). Head movements of the surgeon require to change the focal plane and the zoom value without loosing the calibration. Starting from a previously developed optical see through head mounted display we adapted our HMD to measure the focal and zoom values. We made a series of planar calibrations with seven different fixed zoom and focus values using Tsais algorithm for camera calibration. Then we used the Polaris optical tracking system (Northern Digital, Ontario, Can) to measure the transformation from the planar calibration grid to a tracker probe rigidly mounted to the HMD. Then least squares approximating polynomial surfaces were derived for the seven calibration parameters. Minimizing the object space error in the last step of the procedure we achieved a mean object space error of 0.85 +/- 0.5 mm. Calibration of the HMD is maintained during minor changes in zoom and focus. Employing an automated calibration procedure which utilizes more zoom and focus steps and more accurate measurement of the position of the zoom lenses and the focal plane should reduce the error significantly, improving the accuracy needed for CAS.
No preview · Article · Jan 2003 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: The invention of miniatured electromagnetic tracking systems opened a wide range of new applications. Nevertheless these systems come with some drawbacks which have to overcome. In such a case, most of the problems obviously arise from the interference of the tracking system with the US generator used by the endoscope. As shown with the comparable experiments with the C2-4 scan head, an endoscope equipped with a scan head working on lower or higher frequencies could be tracked with similar accuracy.
No preview · Article · Jan 2003 · Proceedings of SPIE - The International Society for Optical Engineering
[Show abstract][Hide abstract] ABSTRACT: We developed a head-mounted display (HMD) with integrated computer-generated stereoscopic projection of target structures and integrated it into visit, a specific oral implant planning and navigation software. The HMD is equipped with two miniature computer monitors that project computer-generated graphics stereoscopically into the optical path. Its position is tracked by the navigation system's optical tracker and target structures are displayed in their true position over the operation site. In order to test this system's accuracy and spatial perception of the viewer, five interforaminal implants in three dry human mandibles were planned with visit and executed using the stereoscopic projection through the HMD. The deviation between planned and achieved position of the implants was measured on corresponding computed tomography (CT) scan images recorded post-operatively. The deviation between planned and achieved implant position at the jaw crest was 0.57 +/- 0.49 mm measured from the lingual, and 0.58 +/- 0.4 mm measured from the buccal cortex. At the tip of the implants the deviation was 0.77 +/- 0.63 mm at the lingual and 0.79 +/- 0.71 mm at the buccal cortex. The mean angular deviation between planned and executed implant position was 3.55 +/- 2.07 degrees. The present in vitro experiment indicates that the concept of preoperative planning and transfer to the operative field by an HMD allows us to achieve an average precision within 1 mm (range up to 3 mm) of the implant position and within 3 degrees deviation for the implant inclination (range up to 10 degrees ). Control during the drilling procedure is significantly improved by stereoscopic vision through the HMD resulting in a more accurate inclination of the implants.
Preview · Article · Jan 2003 · Clinical Oral Implants Research