Intuitive Surgical Navigation System for Dental Implantology by Using Retinal Imaging Display

As dental implants have become an established treatment, their application to aggressive cases with insufficient quantity and quality of bone has increased. To perform safe and precise surgery, overcoming these difficulties, computer-assisted systems have been developed (Jabero et al., 2006). There are two major classes of these systems, that is, a computer-guided (static) system (Schneider et al., 2009) and a computer-navigated (dynamic) system (Jung et al., 2009). The computer-guided system such as SimPlant software and SurgiGuide (Materialize Dental Inc., USA), NobelGuide (Nobel Biocare Management AG, Sweden), and 10DR (10DR JAPAN Co., Ltd., Japan) are a surgical template based system which can simulate an optimal implant location, angle, direction, depth and size pre-operatively. Our system, BoneNavi (Bionic Inc., Japan), has also been developed to simulate implant placement and the surgical template fabrication for dental implant surgery (Ohtani et al., 2009) and applied in more than 200 clinical cases in Japan (Sohmura et al., 2009). On the other hand, the computer-navigated system such as IGI system (Image Navigation Ltd., USA) offers freehand implant navigation empowered by highly accurate motion tracking technology that tracks the positions of the dental drill and patient throughout the surgery (Casap et al., 2004). It has also already been applied in clinical cases (Casap et al., 2005 & 2008). Advantages and disadvantages of the computerguided system and the computer-navigated system are shown in Table 1. Unlike an open chest surgery and an open abdominal surgery, looking away from the oral cavity (narrow space (Fig.1)) intra-operatively involve a risk of operation errors in case of a dental implant surgery. However, with conventional systems, surgeons have to manipulate instruments in the patient’s oral cavity while watching a surgical monitor as shown in Fig.2(a) and they feel anxious during operations. To overcome this problem, we have been developed a novel surgical navigation system by combining the retinal imaging display (RID) and the augmented reality (AR) techniques