Development and validation of a robotic system for milling individualized jawbone cavities in oral and maxillofacial surgery.

J Dent

State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, National Clinical Research Center for Oral Diseases, Shaanxi Key Laboratory of Stomatology, Digital Center, School of Stomatology, The Fourth Military Medical University, No.145 Changle West Road, Xincheng District, Xi'an, Shaanxi 710032, China. Electronic address:

Published: November 2024

AI Article Synopsis

  • The study focused on creating and testing a robotic system designed for precise and minimally invasive jawbone milling, aimed at improving oral and maxillofacial surgery outcomes.
  • The robotic system includes a UR5E arm and advanced software that generates tailored cutting paths based on 3D models and surgical needs.
  • Results showed that the robotic approach outperformed static guides in terms of accuracy, with better overall precision in milling surgeries, indicating its potential for clinical use.

Article Abstract

Objectives: This study aimed to develop and validate a robotic system capable of performing accurate and minimally invasive jawbone milling procedures in oral and maxillofacial surgery.

Methods: The robotic hardware system mainly includes a UR5E arm (Universal Robots, Denmark) and the binocular positioning system (FusionTrack 250, Atracsys LLC, Switzerland). The robotic software (Dental Navi 3.0.0, Yakebot Technology Ltd., China) is capable of generating cutting tool paths based on three-dimensional shape description files, typically in the stereolithography format, and selected cutting tool parameters, as well as designing surgical accessories. Fully impacted supernumerary tooth models in the maxilla were fabricated using software and three-dimensional printing. Following the planning of a customized cavity to fully expose the tooth, maxillary bone milling was performed on both the robot and static guide groups (n = 8). After milling, all models underwent scanning for assessment.

Results: In the experiment with fully buried supernumerary tooth models in the maxilla, the root mean square, translation error, over-removal rate, and maximum distance were significantly smaller in the robot group compared to the static guide group. Moreover, the overlap ratio and Dice coefficient were significantly greater in the robot group. No statistically significant differences were observed between the two groups in terms of the rotation error (P = 0.80) or under-removal rate (P = 0.92).

Conclusions: This study has developed a robotic system for milling individualized jawbone cavities in oral and maxillofacial surgery, and its accuracy has been preliminarily verified to meet clinical requirements.

Clinical Significance: The robotic system can achieve precise, minimally invasive, individualized jawbone milling in a variety of oral and maxillofacial surgeries, including tooth autotransplantation, surgical reshaping for zygomatic fibrous dysplasia, removal of fully impacted supernumerary or impacted teeth, and endodontic microsurgery, among other relevant clinical applications.

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Source
http://dx.doi.org/10.1016/j.jdent.2024.105380DOI Listing

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