• Title/Summary/Keyword: Virtual surgery

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Rational treatment planning for implant treatment of the edentulous patients (완전무치악환자의 전악 임플란트 치료 계획 수립을 위한 체계적인 접근법)

  • Jeong-In Bae
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.32 no.2
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    • pp.54-68
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    • 2023
  • Treatment planning of edentulous patient with digital method is materialized by designing the surgical guide. When designing the surgical guide, we first implement the shape of the final prosthesis in the virtual space and then materialize the implantation plan based on this. However, it is challenging to make surgical guides for edentulous patients as their lack of both the reference for the arrangement of teeth and interocclusal relationship makes it hard to envision the shape of the final prosthesis. If there exists good partial or complete dentures or residual teeth, its teeth arrangement can be used as a reference for the virtual final prosthesis and the subsequent surgical guide. If such a reference is absent or unsatisfactory, a process of manufacturing a complete denture for diagnostic purposes and verifying it on patient's mouth is necessary and use it as a new reference for the virtual final prosthesis. But even if a surgical guide is produced through the reference from the thorough reflection of the virtual final prosthesis, when we use it in the surgical field, the intraoral condition of the patient may make the implants deviated from planned in the surgical guide. In the worst case, if the positioning of the surgical guide on the mouth is incorrect, it can lead to a catastrophic error that displaces all the implant, in which case the guided surgery would be much worse than the non-guided one. In this article, we will discuss how to obtain references of tooth arrangements in a timely manner and align or register them into a unified coordinate system in digital space, and also introduce how to transfer such an implantation plan from the virtual world into the patient's mouth of real world with minimum error. And lastly, I would like to express my opinion on the establishment of a rational and systematic protocol of guided surgery of the edentulous patients.

Mandible Reconstruction with 3D Virtual Planning

  • Woo, Taeyong;Kraeima, Joep;Kim, Yong Oock;Kim, Young Seok;Roh, Tai Suk;Lew, Dae Hyun;Yun, In Sik
    • Journal of International Society for Simulation Surgery
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    • v.2 no.2
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    • pp.90-93
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    • 2015
  • The fibula free flap has now become the most reliable and frequently used option for mandible reconstruction. Recently, three dimensional images and printing technologies are applied to mandibular reconstruction. We introduce our recent experience of mandibular reconstruction using three dimensionally planned fibula free flap in a patient with gunshot injury. The defect was virtually reconstructed with three-dimensional image. Because bone fragments are dislocated from original position, relocation was necessary. Fragments are virtually relocated to original position using mirror image of unaffected right side of the mandible. A medical rapid prototyping (MRP) model and cutting guide was made with 3D printer. Titanium reconstruction plate was adapted to the MRP model manually. 7 cm-sized fibula bone flap was designed on left lower leg. After dissection, proximal and distal margin of fibula flap was osteotomized by using three dimensional cutting guide. Segmentation was also done as planned. The fibula bone flap was attached to the inner side of the prebent reconstruction plate and fixed with screws. Postoperative evaluation was done by comparison between preoperative planning and surgical outcome. Although dislocated condyle is still not in ideal position, we can see that reconstruction was done as planned.

Recording natural head position using an accelerometer and reconstruction from computed tomographic images

  • Park, Il Kyung;Lee, Keun Young;Jeong, Yeong Kon;Kim, Rae Hyong;Kwon, Dae Gun;Yeon, Sunghee;Kwon, Kyung-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.43 no.4
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    • pp.256-261
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    • 2017
  • Objectives: The concept of natural head position (NHP) was first introduced by Broca in 1862, and was described as a person's stable physiologic position "when a man is standing and his visual axis is horizontal." NHP has been used routinely for clinical examination; however, a patient's head position is random during cone-beam computed tomography (CBCT) acquisition. To solve this problem, we developed an accelerometer to record patients' NHP and reproduce them for CBCT images. In this study, we also tested the accuracy and reproducibility of our accelerometer. Materials and Methods: A total of 15 subjects participated in this study. We invented an accelerometer that measured acceleration on three axes and that could record roll and pitch calculations. Recorded roll and pitch data for each NHP were applied to a reoriented virtual image using three-dimensional (3D) imaging software. The data between the 3D models and the clinical photos were statistically analyzed side by side. Paired t-tests were used to statistically analyze the measurements. Results: The average difference in the angles between the clinical photograph and the 3D model was $0.04^{\circ}$ for roll and $0.29^{\circ}$ for pitch. The paired t-tests for the roll data (P=0.781) and the pitch data (P=0.169) showed no significant difference between the clinical photographs and the 3D model (P>0.05). Conclusion: By overcoming the limitations of previous NHP-recording techniques, our new method can accurately record patient NHP in a time-efficient manner. Our method can also accurately transfer the NHP to a 3D virtual model.

Effect Analysis of Virtual-reality Vestibular Rehabilitation based on Eye-tracking

  • Lee, Sungjin;Hong, Min;Kim, Sungyeup;Choi, Seong Jun
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.14 no.2
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    • pp.826-840
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    • 2020
  • Vertigo is one of the most common complaints encountered by physicians and the patients are steadily increasing. These patients are exposed to the risk of secondary accidents such as falls due to vertigo. There are two ways to improve this symptom: medication and rehabilitation. Although temporary symptomatic improvement may be expected in patients treated with medication, vertigo may recur and medication can delay central compensation. In contrast vestibular rehabilitation exploits central mechanisms of neuroplasticity to increase postural stability and enhance visual-vestibular interactions in situations that generate conflicting sensory information. However, vestibular rehabilitation may be compromised by incorrect performance of exercises, and there is a need for active effort and interest from the patient during rehabilitation. To solve these problems, we decided to apply FOVE HMD for eye-tracking and Unity3D to create virtual reality. The proposed eye-tracking based algorithm calculates the concentration of users with eye tracking data and calculates the motion width of the patient with nystagmus, thus the severity of the patient according to the score can be determined. According to our experimental test against healty group and patients group, this result showed the meaningful data to use define the contents result.

Data-driven Adaptive Safety Monitoring Using Virtual Subjects in Medical Cyber-Physical Systems: A Glucose Control Case Study

  • Chen, Sanjian;Sokolsky, Oleg;Weimer, James;Lee, Insup
    • Journal of Computing Science and Engineering
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    • v.10 no.3
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    • pp.75-84
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    • 2016
  • Medical cyber-physical systems (MCPS) integrate sensors, actuators, and software to improve patient safety and quality of healthcare. These systems introduce major challenges to safety analysis because the patient's physiology is complex, nonlinear, unobservable, and uncertain. To cope with the challenge that unidentified physiological parameters may exhibit short-term variances in certain clinical scenarios, we propose a novel run-time predictive safety monitoring technique that leverages a maximal model coupled with online training of a computational virtual subject (CVS) set. The proposed monitor predicts safety-critical events at run-time using only clinically available measurements. We apply the technique to a surgical glucose control case study. Evaluation on retrospective real clinical data shows that the algorithm achieves 96% sensitivity with a low average false alarm rate of 0.5 false alarm per surgery.

A Study of Biomechanical Simulation Model for Spinal Fusion using Spinal Fixation System (척추경 고정 나사 시스템을 이용한 척추 유합 시술의 생체역학적 분석 모델 연구)

  • Kim, Sung-Min;Yang, In-Chul;Kang, Ho-Chul
    • Journal of the Korean Society for Precision Engineering
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    • v.27 no.2
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    • pp.137-144
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    • 2010
  • In general, spinal fusion surgery takes pressure off the pain induced nerves, by restoring the alignment of the spine. Therefore spinal fixation system is used to maintain the alignment of spine. In this study, a biomechanical study was performed comparing the SROM(Spinal Range Of Motion) of three types of system such as Rigid, Dynesys, and Fused system to analyze the behavior of spinal fixation system inserted in vertebra. Dynesys system, a flexible posterior stabilization system that provides an alternative to fusion, is designed to preserve inter-segmental kinematics and alleviate loading at the facet joints. In this study, SROM of inter-vertebra with spinal fixation system installed in the virtual vertebra from L4 to S1 is estimated. To compare with spinal fixation system, a simulation was performed by BRG. LifeMOD 2005.5.0 was used to create the human virtual model of spinal fixation system. Through this, each SROM of flexion, extension, lateral bending, and axial rotation of human virtual model was measured. The result demonstrates that the movement of Dynesys system was similar to normal condition through allowing the movement of lumbar.

A Force-Reflecting Haptic interface using Ultrasonic Motors (초음파 모터를 이용한 힘 반영 촉각장치)

  • Shin, Duk;Oh, Geum-Kon;Kim, Young-Dong
    • Journal of the Korean Institute of Illuminating and Electrical Installation Engineers
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    • v.13 no.1
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    • pp.111-118
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    • 1999
  • Throughout this thesis, I describe the design, fabrication, and evaluation of the 3 DOF farce-reflecting haptic interface using USMs(ultrasonic motors). This haptic interface allows a htmlaIl "observer" to explore and interact with a virtual environrrent for the sense of touch. To effectively display the mechanical impedance of the htmlaIl hand we need a haptic device with specific characteristics, such as low inertia, alrmst zero friction and very high stiffness. USMs have attracted considerable attention as the actuator satisfied these conditions. An observer may grasp the end effector of revice and interact with surfaces and objects created within a virtual environment The revice provires force feedback, allowing users to "feel" objects within the environment. The device works very well, as users are able to detect the edge of the wall, the stiffness of the button and the puncture. TIle force-reflecting haptic interface could be suitable as a master for micro-surgery or as an interface to virtual reality training systems.

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Late reconstruction of extensive orbital floor fracture with a patient-specific implant in a bombing victim

  • Smeets, Maximiliaan;Snel, Robin;Sun, Yi;Dormaar, Titiaan;Politis, Constantinus
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.46 no.5
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    • pp.353-357
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    • 2020
  • Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patient-specific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. This 58-year-old female suffered severe wounds caused by a single piece of metal from a bomb, shattering the left orbital floor and lateral orbital wall. Due to remaining hypotropia of the left eye compared to the right eye, late orbital floor reconstruction was carried out with a personalised 3D printed titanium implant. We concluded that this technique with PSI appears to be a viable method to correct complex orbital floor defects. Our research group noted good aesthetic and functional results one year after surgery. Due to the complexity of the surgery for a major bony defect of the orbital floor, it is important that the surgery be executed by experienced surgeons in the field of maxillofacial traumatology.

A Study on Preferred Morphologic Feature and Proportion of Facial Aesthetic Subunit by Korean General Public (일반인이 선호하는 얼굴의 미적 단위별 형태와 비율 연구)

  • Yoon, Yong-Il;Lee, Dong-Lark;Yoo, Jung-Seok;Rhee, Seung-Chul;Hur, Gi-Yeun;Kim, Ju-Yeon
    • Archives of Plastic Surgery
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    • v.37 no.4
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    • pp.351-360
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    • 2010
  • Purpose: As the influence of mass media increases, the general standard of attractiveness or beauty of a face also changes. The primary purpose of the study is to find out the factors of the attractive and beautiful face recognized by public. Methods: We picked out standard model photography and operated with Adobe$^{(R)}$ Photoshop$^{(R)}$ and Monariza$^{(R)}$ virtual plastic surgery program. The contour of face, eye, nose, forehead, zygoma, chin and proportion of upper, middle, lower face were changed. The interview survey was conducted through structured standard photo for 310 respondents. That was utilized in the final analysis. Multiple regression analysis was executed by SPSS 12.0. It was used to deal with statistical data and all the other necessary analysis. Results: According to general characteristics of the respondents, many differences were found in preferred face and facial aesthetic subunits. The younger generation preferred the lozenge and inverted triangle shape contour. The respondents over 40 of age preferred the egg shape contour. In chin and zygoma contour, the respondents at the age of 20 preferred distinctly small chin and relatively small lower face. On the other hand, the respondents over 40 of age preferred the wide zygoma relatively. In the proportion of upper, middle, lower face, 51.0% of respondents answered 1 : 1 : 1. If they want to have an aesthetic operation, they preferred protruding forehead. Also they preferred the small chin and V-shaped chin in frontal view. Conclusion: Many respondents preferred to have a plastic surgery for the better facial subunit. The statistical evidence from this study suggests that the harmony and balance of facial aesthetic subunits make attractive and beautiful face.

Immediately loaded dental implants with fixed prostheses using a computer-guided surgery in a mental retardation patient: a case report (정신지체장애환자에서 Computer-Guided Surgery를 이용한 임플란트 식립 및 즉시 보철물 장착: 증례보고)

  • Han, Se-Jin
    • Journal of Dental Rehabilitation and Applied Science
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    • v.30 no.3
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    • pp.246-252
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    • 2014
  • $Br{\aa}nemark^{\prime}s$ original protocol required 4 to 6 months for implant osseointegration before placement of the definitive prosthesis. Although this approach gave very predictable results, it had certain drawbacks. The main disadvantages of this approach were prolonged treatment time, two surgical procedures, placement of a removable prosthesis that required modifications during the course of treatment, and a greater number of appointments. Immediate implant loading is a viable treatment method for selected cases. One of the greatest advantages of this method is the virtual surgery, which precedes the actual clinical treatment and eliminates any need for last minute decisions. The actual surgery time is decreased, since all steps are predetermined. These advantages aren't only more useful for normal patients but also for the mental retardation patients whose cooperation is difficult. This article presents a clinical approach made possible due to the guided implant surgery and CAD/CAM technique.