Guided Implant Surgery using Free and Open Source Software (3D Slicer)

Chapters:
0:00:00 3D Slicer- Intro and Download
0:02:35 Import CT Study and Multiplanar View
0:08:52 Load and Visualization of Volume(s)
0:14:39 Crop Volume
0:16:16 Segmentation Methods-I
0:23:05 Segmentation Methods-II
0:29:54 Segmentation Methods-III
0:36:41 Segmentation Methods-IV
0:48:27 Planning the Mandibular Nerve
0:54:24 Registration Example
1:06:44 Creating an Implant Model Set
1:14:30 Implant Planning - Virtual Mirroring and Multiplanar Reformation
1:25:30 Implant Planning - Model Design and Registration
1:31:12 An example of Multiple Implant Set Registration
1:31:51 Creating a surgical Guide
1:43:23 Accuracy Evaluation of Implant Placement


Summary:

The basic concept is to explore the possibility of using and developing free and open source software as an alternative to commercial dental software in which the whole sequence of preparation of the working layout, implant planning, guide design and calculation of accuracy without postoperative computed tomography could be performed.

Such a sequence could be acronymized as PIGA sequence derived from the initials of Preparation, Implant, Guide and Accuracy.

In this context, the 3D Slicer software (https://www.slicer.org) that is a free and open source software platform for medical image informatics, image processing, and three-dimensional visualization was used. The literature related to open-source solutions in dentistry appears limited. There are, however, research efforts and some have indeed led to clinical applications.

Such a PIGA sequence with clinical applications will also be presented at the CARS 2021(Computer Assisted Radiology and Surgery Congress, Munich 21-25/6/2021)(https://www.cars-int.org). Results regarding the accuracy of half-guided dental implant placement were consistent with literature.

Although the workflow presented in the video seems complex and time consuming there is, however, a great potential for improvements following a proper collaboration of software engineers and clinicians so that a 3D Slicer-based PIGA workflow can be generated in order for it to be clinically usable.

Read more at the "Open Source Guided Surgery"(https://gnathion.gr/guided) which is a site dedicated to clinical applications of guided oral surgery and rehabilitation based on free and open source software.