Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Merkl, M.
The use of augmented and virtual reality in clinical oral and maxillofacial surgery: A review of literature.
Zahnmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 71
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Wallner Jürgen
- Zemann Wolfgang
- Altmetrics:
- Abstract:
- Background: In the last two decades three-dimensional (3D) visualization technologies have become part of our daily life. In the field of oral and maxillofacial surgery 3D visualization technologies such as augmented reality (AR) and virtual reality (VR) are of great interest, because these technologies offer the opportunity to visualize complex anatomical conditions in three dimensions and in real time directly on the patient. AR and VR are assumed to have great potential to better understand complex physiological and pathological conditions pre- and intraoperatively and increase diagnostic accuracy and treatment outcome. Although many works have been published in the literature that outline various novel highly promising AR and VR applications in oral and maxillofacial surgery, none of them provides so far a clear consensus, a clear description of limitations or levels of evidence about their real clinical potential. Therefore, the aim of this work was to review the literature in order to evaluate the clinical potential and to provide an overall level of evidence of the existing research to date regarding AR and VR in oral and maxillofacial surgery. Methods: A literature search on PubMed, Mendeley and the Web of Science was conducted. For the electronic data research, the following keywords were used: “virtual reality maxillofacial” and “augmented reality maxillofacial”. Only already published or accepted papers were used. After applying predefined inclusion and exclusion criteria, the remaining papers were reviewed in order to give a state-of- the-art overview of the clinical potential of AR and VR in oral and maxillofacial surgery. Results: 56 original papers and 3 reviews were found with the keywords “augmented reality maxillofacial.” The main focus for AR papers was related to “protection of the infra alveolar nerve” (n=2), “orthognathic” (n=7), “reconstruction” (n=6), “tumor resection” (n=8), “dental implants” (n=4) and “system accuracy” (n=11). The search with the keywords “virtual reality maxillofacial” showed 89 original studies and 5 reviews. The main focus for VR papers was related to “teaching” (n=11), “planning” (n=8) and “virtual reality in preoperative anxiety patients” (n=2). After the selection process 36 papers on augmented reality and 26 papers on VR were included in this review. The level of evidence found in the literature showed evidence grades between Ib and V for VR technologies and IIIa and V for AR technologies There was no evidence level found for AR applications higher than IIIa and for VR applications higher than Ib. Comparative clinical studies are completely missing so far. Discussion: VR has great potential in clinical education and 3D surgical planning. Intraoperative use of VR can lead to lower stress level of the patient. AR is mainly used in an intraoperative setting. In particular, superimposing surgical plans and important anatomical structures are of great interest. Due to the higher accuracy achieved by using hard tissues as reference for registration, augmented reality is so far especially convenient for surgeries concerning hard tissue structures like bone or teeth. Although more original papers were found related to AR, a higher level of evidence was found for VR applications. Conclusion: Although the use of VR and AR applications show great potential in clinical oral and maxillofacial surgery, so far no functional stable technology could yet have been established for the clinical practice. The level of evidence in the published literature was found to remain low, especially for AR applications, which mainly seem to be used in early stage pilot projects regarding a clinical use. Therefore, studies with higher levels of evidence, comparative assessments and practical implementations, especially for AR applications, are necessary, in order to further develop and establish these technologies in the clinical routine.