Application of augmented reality navigation in oral surgery

BACKGROUND: Augmented reality is a potential alternative for surgical navigation, as it can provide visualization of various anatomical structures of the maxillofacial region. We have developed a specific platform for three-dimensional model management and intraoperative augmented reality navigation for surgical procedures. AIM: To evaluate surgeons’ perceptions and the usability of augmented reality navigation for the most common surgical procedures in oral surgery. MATERIALS AND METHODS: We performed a phantom study to determine the accuracy of the augmented reality system in the maxillofacial region. Registration errors typical in image-guided surgery were measured: fiducial registration error, target registration error, and fiducial localization error. Thereafter, a clinical trial with several surgeons performing surgical procedures on jaws using augmented reality technology was conducted. Surgeons filled out a dedicated questionnaire after their experience with augmented reality navigation. RESULTS: The mean fiducial registration error was 0.9 mm (standard deviation 0.7 mm; 95% confidence interval 0.4–1.3 mm). The mean target registration error was 1.3 mm (standard deviation 0.5 mm; 95% confidence interval 1.1–1.5 mm). The fiducial localization error was the most significant with 2.2 mm (standard deviation 0.9; 95% confidence interval 1.9–2.5 mm). The higher rankings in the user experience questionnaire were related to the novelty and excitement of using augmented reality navigation in maxillofacial surgery. The pragmatic quality aspect explains the technical focus of perception to achieve goals in a product, system, or service design. Efficiency was expected to be slightly higher; however, in our opinion, this is due to the technical difficulties of the system for novel augmented reality technology. CONCLUSION: The results revealed the satisfactory accuracy of the augmented reality system in the maxillofacial region and the user experience of the augmented reality navigation system for oral surgery.