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1.
Sensors (Basel) ; 23(9)2023 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-37177725

RESUMO

Recent years have witnessed relevant advancements in the quality of life of persons with lower limb amputations thanks to the technological developments in prosthetics. However, prostheses that provide information about the foot-ground interaction, and in particular about terrain irregularities, are still missing on the market. The lack of tactile feedback from the foot sole might lead subjects to step on uneven terrains, causing an increase in the risk of falling. To address this issue, a biomimetic vibrotactile feedback system that conveys information about gait and terrain features sensed by a dedicated insole has been assessed with intact subjects. After having shortly experienced both even and uneven terrains, the recruited subjects discriminated them with an accuracy of 87.5%, solely relying on the replay of the vibrotactile feedback. With the objective of exploring the human decoding mechanism of the feedback startegy, a KNN classifier was trained to recognize the uneven terrains. The outcome suggested that the subjects achieved such performance with a temporal dynamics of 45 ms. This work is a leap forward to assist lower-limb amputees to appreciate the floor conditions while walking, adapt their gait and promote a more confident use of their artificial limb.


Assuntos
Amputados , Membros Artificiais , Humanos , Retroalimentação , Tecnologia Háptica , Qualidade de Vida , Extremidade Inferior , , Caminhada , Marcha , Fenômenos Biomecânicos
2.
Neurol Sci ; 42(12): 5369-5372, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34406536

RESUMO

INTRODUCTION/AIMS: The hand is a sophisticated tool which allows humans to interact with the external world mainly via the sense of touch. Previous evidences demonstrated that electrical stimulations of the nerve trunks governing the hand are able to restore touch perception in transradial amputees. The aim of this study was to evaluate the neurological correlates of restored perception by the evaluation of network characteristics of the brain connectome via EEG recordings in amputees utilizing a fully sensorized bionic hand. METHODS: A 48-year-old female with a left wrist traumatic disarticulation incurred 23 years prior to the study was enrolled for 6 months, during which experimental sessions were randomized. The control group included 12 healthy subjects performing a similar protocol. RESULTS: Results showed that in both amputee and control group, a trend of SW in delta and beta 1 is recognizable (Delta and Beta 1 opposite spread) selectively in the hemisphere contralateral to the stimulus. DISCUSSION: Delta increases (less orderly network) while Beta 1 decreases (more ordered network). It could be seen as a sign of higher attention and concentration of subjects to understand the perception and this monolateral modulation is similar to the bilateral attention given to the mathematical task difficulty's increment.


Assuntos
Amputados , Percepção do Tato , Biomimética , Encéfalo/diagnóstico por imagem , Encéfalo/cirurgia , Feminino , Mãos , Humanos , Pessoa de Meia-Idade
3.
Sensors (Basel) ; 20(5)2020 Mar 06.
Artigo em Inglês | MEDLINE | ID: mdl-32155900

RESUMO

This paper reviews automated visual-based defect detection approaches applicable to various materials, such as metals, ceramics and textiles. In the first part of the paper, we present a general taxonomy of the different defects that fall in two classes: visible (e.g., scratches, shape error, etc.) and palpable (e.g., crack, bump, etc.) defects. Then, we describe artificial visual processing techniques that are aimed at understanding of the captured scenery in a mathematical/logical way. We continue with a survey of textural defect detection based on statistical, structural and other approaches. Finally, we report the state of the art for approaching the detection and classification of defects through supervised and non-supervised classifiers and deep learning.

4.
Sensors (Basel) ; 20(4)2020 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-32098102

RESUMO

This study presents an improved strategy for the detection and localization of small size nodules (down to few mm) of agar in excised pork liver tissues via pulse-echo ultrasound measurements performed with a 16 MHz needle probe. This work contributes to the development of a new generation of medical instruments to support robotic surgery decision processes that need information about cancerous tissues in a short time (minutes). The developed ultrasonic probe is part of a scanning platform designed for the automation of surgery-associated histological analyses. It was coupled with a force sensor to control the indentation of tissue samples placed on a steel plate. For the detection of nodules, we took advantage of the property of nodules of altering not only the acoustical properties of tissues producing ultrasound attenuation, but also of developing patterns at their boundary that can modify the shape and the amplitude of the received echo signals from the steel plate supporting the tissues. Besides the Correlation Index Amplitude (CIA), which is linked to the overall amplitude changes of the ultrasonic signals, we introduced the Correlation Index Shape (CIS) linked to their shape changes. Furthermore, we applied AND-OR logical operators to these correlation indices. The results were found particularly helpful in the localization of the irregular masses of agar we inserted into some excised liver tissues, and in the individuation of the regions of major interest over which perform the vertical dissections of tissues in an automated analysis finalized to histopathology. We correctly identified up to 89% of inclusions, with an improvement of about 14% with respect to the result obtained (78%) from the analysis performed with the CIA parameter only.


Assuntos
Fígado/patologia , Fígado/cirurgia , Procedimentos Cirúrgicos Robóticos/métodos , Animais , Humanos , Suínos
5.
Sensors (Basel) ; 20(2)2020 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-31963696

RESUMO

Musculoskeletal disorders are the most common form of occupational ill-health. Neck pain is one of the most prevalent musculoskeletal disorders experienced by computer workers. Wrong postural habits and non-compliance of the workstation to ergonomics guidelines are the leading causes of neck pain. These factors may also alter respiratory functions. Health and safety interventions can reduce neck pain and, more generally, the symptoms of musculoskeletal disorders and reduce the consequent economic burden. In this work, a multi-parametric wearable system based on two fiber Bragg grating sensors is proposed for monitoring neck movements and breathing activity of computer workers. The sensing elements were positioned on the neck, in the frontal and sagittal planes, to monitor: (i) flexion-extension and axial rotation repetitions, and (ii) respiratory frequency. In this pilot study, five volunteers were enrolled and performed five repetitions of both flexion-extension and axial rotation, and ten breaths of both quite breathing and tachypnea. Results showed the good performances of the proposed system in monitoring the aforementioned parameters when compared to optical reference systems. The wearable system is able to well-match the trend in time of the neck movements (both flexion-extension and axial rotation) and to estimate mean and breath-by-breath respiratory frequency values with percentage errors ≤6.09% and ≤1.90%, during quiet breathing and tachypnea, respectively.


Assuntos
Monitorização Fisiológica/métodos , Pescoço/fisiologia , Taxa Respiratória/fisiologia , Dispositivos Eletrônicos Vestíveis , Adulto , Computadores , Ergonomia , Feminino , Humanos , Masculino , Monitorização Fisiológica/instrumentação , Projetos Piloto , Processamento de Sinais Assistido por Computador , Adulto Jovem
6.
J Neurosci ; 38(15): 3669-3679, 2018 04 11.
Artigo em Inglês | MEDLINE | ID: mdl-29540549

RESUMO

The presence of contralateral tactile input can profoundly affect ipsilateral tactile perception, and unilateral stroke in somatosensory areas can result in bilateral tactile deficits, suggesting that bilateral tactile integration is an important part of brain function. Although previous studies have shown that bilateral tactile inputs exist and that there are neural interactions between inputs from the two sides, no previous study explored to what extent the local neuronal circuitry processing contains detailed information about the nature of the tactile input from the two sides. To address this question, we used a recently introduced approach to deliver a set of electrical, reproducible, tactile afferent, spatiotemporal activation patterns, which permits a high-resolution analysis of the neuronal decoding capacity, to the skin of the second forepaw digits of the anesthetized male rat. Surprisingly, we found that individual neurons of the primary somatosensory can decode contralateral and ipsilateral input patterns to comparable extents. Although the contralateral input was stronger and more rapidly decoded, given sufficient poststimulus processing time, ipsilateral decoding levels essentially caught up to contralateral levels. Moreover, there was a weak but significant correlation for neurons with high decoding performance for contralateral tactile input to also perform well on decoding ipsilateral input. Our findings shed new light on the brain mechanisms underlying bimanual haptic integration.SIGNIFICANCE STATEMENT Here we demonstrate that the spiking activity of single neocortical neurons in the somatosensory cortex of the rat can be used to decode patterned tactile stimuli delivered to the distal ventral skin of the second forepaw digits on both sides of the body. Even though comparable levels of decoding of the tactile input were achieved faster for contralateral input, given sufficient integration time each neuron was found to decode ipsilateral input with a comparable level of accuracy. Given that the neocortical neurons could decode ipsilateral inputs with such small differences between the patterns suggests that S1 cortex has access to very precise information about ipsilateral events. The findings shed new light on possible network mechanisms underlying bimanual haptic processing.


Assuntos
Neocórtex/fisiologia , Neurônios/fisiologia , Percepção do Tato , Animais , Potenciais Somatossensoriais Evocados , Lateralidade Funcional , Masculino , Neocórtex/citologia , Ratos , Ratos Sprague-Dawley , Tempo de Reação
7.
Sensors (Basel) ; 19(3)2019 Feb 03.
Artigo em Inglês | MEDLINE | ID: mdl-30717482

RESUMO

Advancements in the study of the human sense of touch are fueling the field of haptics. This is paving the way for augmenting sensory perception during object palpation in tele-surgery and reproducing the sensed information through tactile feedback. Here, we present a novel tele-palpation apparatus that enables the user to detect nodules with various distinct stiffness buried in an ad-hoc polymeric phantom. The contact force measured by the platform was encoded using a neuromorphic model and reproduced on the index fingertip of a remote user through a haptic glove embedding a piezoelectric disk. We assessed the effectiveness of this feedback in allowing nodule identification under two experimental conditions of real-time telepresence: In Line of Sight (ILS), where the platform was placed in the visible range of a user; and the more demanding Not In Line of Sight (NILS), with the platform and the user being 50 km apart. We found that the entailed percentage of identification was higher for stiffer inclusions with respect to the softer ones (average of 74% within the duration of the task), in both telepresence conditions evaluated. These promising results call for further exploration of tactile augmentation technology for telepresence in medical interventions.


Assuntos
Retroalimentação Sensorial/fisiologia , Palpação/instrumentação , Dedos/fisiologia , Gestos , Luvas Protetoras , Humanos , Imagens de Fantasmas , Tato/fisiologia , Interface Usuário-Computador
8.
Sensors (Basel) ; 19(11)2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31159334

RESUMO

This study presents a platform for ex-vivo detection of cancer nodules, addressing automation of medical diagnoses in surgery and associated histological analyses. The proposed approach takes advantage of the property of cancer to alter the mechanical and acoustical properties of tissues, because of changes in stiffness and density. A force sensor and an ultrasound probe were combined to detect such alterations during force-regulated indentations. To explore the specimens, regardless of their orientation and shape, a scanned area of the test sample was defined using shape recognition applying optical background subtraction to the images captured by a camera. The motorized platform was validated using seven phantom tissues, simulating the mechanical and acoustical properties of ex-vivo diseased tissues, including stiffer nodules that can be encountered in pathological conditions during histological analyses. Results demonstrated the platform's ability to automatically explore and identify the inclusions in the phantom. Overall, the system was able to correctly identify up to 90.3% of the inclusions by means of stiffness in combination with ultrasound measurements, paving pathways towards robotic palpation during intraoperative examinations.


Assuntos
Neoplasias/diagnóstico por imagem , Robótica , Animais , Humanos , Ultrassonografia
9.
Sensors (Basel) ; 19(16)2019 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-31426480

RESUMO

In precision sports, the control of breathing and heart rate is crucial to help the body to remain stable in the shooting position. To improve stability, archers try to adopt similar breathing patterns and to have a low heartbeat during each shot. We proposed an easy-to-use and unobtrusive smart textile (ST) which is able to detect chest wall excursions due to breathing and heart beating. The sensing part is based on two FBGs housed into a soft polymer matrix to optimize the adherence to the chest wall and the system robustness. The ST was assessed on volunteers to figure out its performance in the estimation of respiratory frequency (fR) and heart rate (HR). Then, the system was tested on two archers during four shooting sessions. This is the first study to monitor cardio-respiratory activity on archers during shooting. The good performance of the ST is supported by the low mean absolute percentage error for fR and HR estimation (≤1.97% and ≤5.74%, respectively), calculated with respect to reference signals (flow sensor for fR, photopletismography sensor for HR). Moreover, results showed the capability of the ST to estimate fR and HR during different phases of shooting action. The promising results motivate future investigations to speculate about the influence of fR and HR on archers' performance.


Assuntos
Frequência Cardíaca/fisiologia , Monitorização Fisiológica/métodos , Adulto , Feminino , Humanos , Masculino , Respiração , Esportes , Dispositivos Eletrônicos Vestíveis , Adulto Jovem
10.
Sensors (Basel) ; 18(1)2018 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-29342076

RESUMO

We present a tactile telepresence system for real-time transmission of information about object stiffness to the human fingertips. Experimental tests were performed across two laboratories (Italy and Ireland). In the Italian laboratory, a mechatronic sensing platform indented different rubber samples. Information about rubber stiffness was converted into on-off events using a neuronal spiking model and sent to a vibrotactile glove in the Irish laboratory. Participants discriminated the variation of the stiffness of stimuli according to a two-alternative forced choice protocol. Stiffness discrimination was based on the variation of the temporal pattern of spikes generated during the indentation of the rubber samples. The results suggest that vibrotactile stimulation can effectively simulate surface stiffness when using neuronal spiking models to trigger vibrations in the haptic interface. Specifically, fractional variations of stiffness down to 0.67 were significantly discriminated with the developed neuromorphic haptic interface. This is a performance comparable, though slightly worse, to the threshold obtained in a benchmark experiment evaluating the same set of stimuli naturally with the own hand. Our paper presents a bioinspired method for delivering sensory feedback about object properties to human skin based on contingency-mimetic neuronal models, and can be useful for the design of high performance haptic devices.


Assuntos
Dedos , Humanos , Itália , Tato , Percepção do Tato , Vibração
12.
Brain Topogr ; 30(4): 473-485, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28497235

RESUMO

The sense of touch is fundamental for daily behavior. The aim of this work is to understand the neural network responsible for touch processing during a prolonged tactile stimulation, delivered by means of a mechatronic platform by passively sliding a ridged surface under the subject's fingertip while recording the electroencephalogram (EEG). We then analyzed: (i) the temporal features of the Somatosensory Evoked Potentials and their topographical distribution bilaterally across the cortex; (ii) the associated temporal modulation of the EEG frequency bands. Long-latency SEP were identified with the following physiological sequence P100-N140-P240. P100 and N140 were bilateral potentials with higher amplitude in the contralateral hemisphere and with delayed latency in the ipsilateral side. Moreover, we found a late potential elicited around 200 ms after the stimulation was stopped, which likely encoded the end of tactile input. The analysis of cortical oscillations indicated an initial increase in the power of theta band (4-7 Hz) for 500 ms after the stimulus onset followed a decrease in the power of the alpha band (8-15 Hz) that lasted for the remainder of stimulation. This decrease was prominent in the somatosensory cortex and equally distributed in both contralateral and ipsilateral hemispheres. This study shows that prolonged stimulation of the human fingertip engages the cortex in widespread bilateral processing of tactile information, with different modulations of the theta and alpha bands across time.


Assuntos
Potenciais Somatossensoriais Evocados/fisiologia , Dedos/fisiologia , Córtex Somatossensorial/fisiologia , Tato/fisiologia , Eletroencefalografia , Feminino , Humanos , Masculino , Estimulação Física , Análise Espaço-Temporal , Adulto Jovem
13.
Sensors (Basel) ; 17(8)2017 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-28796170

RESUMO

One of the crucial actions to be performed during a grasping task is to avoid slippage. The human hand can rapidly correct applied forces and prevent a grasped object from falling, thanks to its advanced tactile sensing. The same capability is hard to reproduce in artificial systems, such as robotic or prosthetic hands, where sensory motor coordination for force and slippage control is very limited. In this paper, a novel algorithm for slippage detection is presented. Based on fast, easy-to-perform processing, the proposed algorithm generates an ON/OFF signal relating to the presence/absence of slippage. The method can be applied either on the raw output of a force sensor or to its calibrated force signal, and yields comparable results if applied to both normal or tangential components. A biomimetic fingertip that integrates piezoresistive MEMS sensors was employed for evaluating the method performance. Each sensor had four units, thus providing 16 mono-axial signals for the analysis. A mechatronic platform was used to produce relative movement between the finger and the test surfaces (tactile stimuli). Three surfaces with submillimetric periods were adopted for the method evaluation, and 10 experimental trials were performed per each surface. Results are illustrated in terms of slippage events detection and of latency between the slippage itself and its onset.

14.
Sensors (Basel) ; 16(2): 208, 2016 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-26861333

RESUMO

Vision-based Pose Estimation (VPE) represents a non-invasive solution to allow a smooth and natural interaction between a human user and a robotic system, without requiring complex calibration procedures. Moreover, VPE interfaces are gaining momentum as they are highly intuitive, such that they can be used from untrained personnel (e.g., a generic caregiver) even in delicate tasks as rehabilitation exercises. In this paper, we present a novel master-slave setup for hand telerehabilitation with an intuitive and simple interface for remote control of a wearable hand exoskeleton, named HX. While performing rehabilitative exercises, the master unit evaluates the 3D position of a human operator's hand joints in real-time using only a RGB-D camera, and commands remotely the slave exoskeleton. Within the slave unit, the exoskeleton replicates hand movements and an external grip sensor records interaction forces, that are fed back to the operator-therapist, allowing a direct real-time assessment of the rehabilitative task. Experimental data collected with an operator and six volunteers are provided to show the feasibility of the proposed system and its performances. The results demonstrate that, leveraging on our system, the operator was able to directly control volunteers' hands movements.


Assuntos
Mãos/fisiologia , Movimento/fisiologia , Robótica/métodos , Telerreabilitação/instrumentação , Algoritmos , Fenômenos Biomecânicos , Humanos , Interface Usuário-Computador , Voluntários
15.
Sensors (Basel) ; 14(1): 1073-93, 2014 Jan 09.
Artigo em Inglês | MEDLINE | ID: mdl-24412902

RESUMO

This paper introduces the design and development of a novel pressure-sensitive foot insole for real-time monitoring of plantar pressure distribution during walking. The device consists of a flexible insole with 64 pressure-sensitive elements and an integrated electronic board for high-frequency data acquisition, pre-filtering, and wireless transmission to a remote data computing/storing unit. The pressure-sensitive technology is based on an optoelectronic technology developed at Scuola Superiore Sant'Anna. The insole is a low-cost and low-power battery-powered device. The design and development of the device is presented along with its experimental characterization and validation with healthy subjects performing a task of walking at different speeds, and benchmarked against an instrumented force platform.


Assuntos
Técnicas Biossensoriais , Marcha/fisiologia , Caminhada/fisiologia , Fenômenos Biomecânicos , Humanos , Pressão , Software
16.
Sensors (Basel) ; 14(12): 23781-802, 2014 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-25615726

RESUMO

The development of a bio-hybrid tactile sensor array that incorporates a skin analogue comprised of alginate encapsulated fibroblasts is described. The electrical properties are modulated by mechanical stress induced during contact, and changes are detected by a ten-channel dual-electrode impedance sensing array. By continuously monitoring the impedance of the sensor array at a fixed frequency, whilst normal and tangential loads are applied to the skin surface, transient mechanotransduction has been observed. The results demonstrate the effectiveness and feasibility of the preliminary prototype bio-hybrid tactile sensor.


Assuntos
Técnicas Biossensoriais , Pele Artificial , Tato/fisiologia , Impedância Elétrica , Eletrodos , Humanos , Mecanotransdução Celular/fisiologia
17.
Sensors (Basel) ; 14(3): 4755-90, 2014 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-24618725

RESUMO

This paper reviews the state of the art in piezoelectric energy harvesting. It presents the basics of piezoelectricity and discusses materials choice. The work places emphasis on material operating modes and device configurations, from resonant to non-resonant devices and also to rotational solutions. The reviewed literature is compared based on power density and bandwidth. Lastly, the question of power conversion is addressed by reviewing various circuit solutions.

18.
Biophys Rev (Melville) ; 5(2): 021401, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38895135

RESUMO

Microelectrode recordings from human peripheral and cranial nerves provide a means to study both afferent and efferent axonal signals at different levels of detail, from multi- to single-unit activity. Their analysis can lead to advancements both in diagnostic and in the understanding of the genesis of neural disorders. However, most of the existing computational toolboxes for the analysis of microneurographic recordings are limited in scope or not open-source. Additionally, conventional burst-based metrics are not suited to analyze pathological conditions and are highly sensitive to distance of the microelectrode tip from the active axons. To address these challenges, we developed an open-source toolbox that offers advanced analysis capabilities for studying neuronal reflexes and physiological responses to peripheral nerve activity. Our toolbox leverages the observation of temporal sequences of action potentials within inherently cyclic signals, introducing innovative methods and indices to enhance analysis accuracy. Importantly, we have designed our computational toolbox to be accessible to novices in biomedical signal processing. This may include researchers and professionals in healthcare domains, such as clinical medicine, life sciences, and related fields. By prioritizing user-friendliness, our software application serves as a valuable resource for the scientific community, allowing to extract advanced metrics of neural activity in short time and evaluate their impact on other physiological variables in a consistent and standardized manner, with the final aim to widen the use of microneurography among researchers and clinicians.

19.
Sensors (Basel) ; 13(2): 1435-66, 2013 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-23348032

RESUMO

This paper reviews the state of the art of artificial tactile sensing, with a particular focus on bio-hybrid and fully-biological approaches. To this aim, the study of physiology of the human sense of touch and of the coding mechanisms of tactile information is a significant starting point, which is briefly explored in this review. Then, the progress towards the development of an artificial sense of touch are investigated. Artificial tactile sensing is analysed with respect to the possible approaches to fabricate the outer interface layer: synthetic skin versus bio-artificial skin. With particular respect to the synthetic skin approach, a brief overview is provided on various technologies and transduction principles that can be integrated beneath the skin layer. Then, the main focus moves to approaches characterized by the use of bio-artificial skin as an outer layer of the artificial sensory system. Within this design solution for the skin, bio-hybrid and fully-biological tactile sensing systems are thoroughly presented: while significant results have been reported for the development of tissue engineered skins, the development of mechanotransduction units and their integration is a recent trend that is still lagging behind, therefore requiring research efforts and investments. In the last part of the paper, application domains and perspectives of the reviewed tactile sensing technologies are discussed.


Assuntos
Pele Artificial , Tato/fisiologia , Animais , Humanos , Mecanotransdução Celular , Fenômenos Fisiológicos da Pele
20.
Bioengineering (Basel) ; 10(7)2023 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-37508792

RESUMO

BACKGROUND: This overview aimed to characterize the type, development, and use of haptic technologies for maxillofacial surgical purposes. The work aim is to summarize and evaluate current advantages, drawbacks, and design choices of presented technologies for each field of application in order to address and promote future research as well as to provide a global view of the issue. METHODS: Relevant manuscripts were searched electronically through Scopus, MEDLINE/PubMed, and Cochrane Library databases until 1 November 2022. RESULTS: After analyzing the available literature, 31 articles regarding tactile sensors and interfaces, sensorized tools, haptic technologies, and integrated platforms in oral and maxillofacial surgery have been included. Moreover, a quality rating is provided for each article following appropriate evaluation metrics. DISCUSSION: Many efforts have been made to overcome the technological limits of computed assistant diagnosis, surgery, and teaching. Nonetheless, a research gap is evident between dental/maxillofacial surgery and other specialties such as endovascular, laparoscopic, and microsurgery; especially for what concerns electrical and optical-based sensors for instrumented tools and sensorized tools for contact forces detection. The application of existing technologies is mainly focused on digital simulation purposes, and the integration into Computer Assisted Surgery (CAS) is far from being widely actuated. Virtual reality, increasingly adopted in various fields of surgery (e.g., sino-nasal, traumatology, implantology) showed interesting results and has the potential to revolutionize teaching and learning. A major concern regarding the actual state of the art is the absence of randomized control trials and the prevalence of case reports, retrospective cohorts, and experimental studies. Nonetheless, as the research is fast growing, we can expect to see many developments be incorporated into maxillofacial surgery practice, after adequate evaluation by the scientific community.

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