Haptic Rendering of Diverse Tool-Tissue Contact Constraints During Dental Implantation Procedures.

Motor skill learning of dental implantation surgery is difficult for novices because it involves fine manipulation of different dental tools to fulfill a strictly pre-defined procedure. Haptics-enabled virtual reality training systems provide a promising tool for surgical skill learning. In this paper, we introduce a haptic rendering algorithm for simulating diverse tool-tissue contact constraints during dental implantation. Motion forms of an implant tool can be summarized as the high degree of freedom (H-DoF) motion and the low degree of freedom (L-DoF) motion. During the H-DoF state, the tool can move freely on bone surface and in free space with 6 DoF. While during the L-DoF state, the motion degrees are restrained due to the constraints imposed by the implant bed. We propose a state switching framework to simplify the simulation workload by rendering the H-DoF motion state and the L-DoF motion state separately, and seamless switch between the two states by defining an implant criteria as the switching judgment. We also propose the virtual constraint method to render the L-DoF motion, which are different from ordinary drilling procedures as the tools should obey different axial constraint forms including sliding, drilling, screwing and perforating. The virtual constraint method shows efficiency and accuracy in adapting to different kinds of constraint forms, and consists of three core steps, including defining the movement axis, projecting the configuration difference, and deriving the movement control ratio. The H-DoF motion on bone surface and in free space is simulated through the previously proposed virtual coupling method. Experimental results illustrated that the proposed method could simulate the 16 different phases of the complete implant procedures of the Straumann® Bone Level(BL) Implants Φ4.8-L12 mm. According to the output force curve, different contact constraints could be rendered with steady and continuous output force during the operation procedures.

Preliminary evaluation of a virtual reality dental simulation system on drilling operation.

To evaluate the fidelity of the iDental system and investigate its utility and performance on simulated drilling operations, user studies consisting of objective and subjective evaluations were performed. A voxel-based drilling simulation sub-system in the iDental system was employed for evaluation. Twenty participants were enrolled to take part in the experiments and were divided into two groups: novice and resident. A combined evaluation method including objective and subjective methods was employed. The objective evaluation included two dental drilling tasks: caries removal operation and pulp chamber opening operation. In the subjective method, participants were required to complete a questionnaire to evaluate the fidelity of the system after the operation task. Based on the structured global assessment scales in the questionnaire, the average subjective evaluation scores of the proposed metrics were greater than 4.5, demonstrating that the system operated above medium fidelity. Dentists expressed great interest and positive attitudes toward the potential of the iDental system. The objective evaluation data including time spent and the volume of removed healthy and carious tissue were obtained. Although no significant differences could be found between the two groups, the volume of removed caries and the depth of pulp chamber insertion manifested small standard deviations. Evaluation results illustrated that dentists were willing to use the virtual reality training system. Several future research topics were identified, including increasing the task difficulty, improving the system fidelity and introducing appropriate finger rest points.

Controlling dental enamel-cavity ablation depth with optimized stepping parameters along the focal plane normal using a three axis, numerically controlled picosecond laser.

OBJECTIVE: The purpose of this study was to establish a depth-control method in enamel-cavity ablation by optimizing the timing of the focal-plane-normal stepping and the single-step size of a three axis, numerically controlled picosecond laser. BACKGROUND DATA: Although it has been proposed that picosecond lasers may be used to ablate dental hard tissue, the viability of such a depth-control method in enamel-cavity ablation remains uncertain. METHODS: Forty-two enamel slices with approximately level surfaces were prepared and subjected to two-dimensional ablation by a picosecond laser. The additive-pulse layer, n, was set to 5, 10, 15, 20, 25, 30, 35, 40, 45, 50, 55, 60, 65, 70. A three-dimensional microscope was then used to measure the ablation depth, d, to obtain a quantitative function relating n and d. Six enamel slices were then subjected to three dimensional ablation to produce 10 cavities, respectively, with additive-pulse layer and single-step size set to corresponding values. The difference between the theoretical and measured values was calculated for both the cavity depth and the ablation depth of a single step. These were used to determine minimum-difference values for both the additive-pulse layer (n) and single-step size (d). RESULTS: When the additive-pulse layer and the single-step size were set 5 and 45, respectively, the depth error had a minimum of 2.25 µm, and 450 µm deep enamel cavities were produced. CONCLUSIONS: When performing three-dimensional ablating of enamel with a picosecond laser, adjusting the timing of the focal-plane-normal stepping and the single-step size allows for the control of ablation-depth error to the order of micrometers.

Method to control depth error when ablating human dentin with numerically controlled picosecond laser: a preliminary study.

A three-axis numerically controlled picosecond laser was used to ablate dentin to investigate the quantitative relationships among the number of additive pulse layers in two-dimensional scans starting from the focal plane, step size along the normal of the focal plane (focal plane normal), and ablation depth error. A method to control the ablation depth error, suitable to control stepping along the focal plane normal, was preliminarily established. Twenty-four freshly removed mandibular first molars were cut transversely along the long axis of the crown and prepared as 48 tooth sample slices with approximately flat surfaces. Forty-two slices were used in the first section. The picosecond laser was 1,064 nm in wavelength, 3 W in power, and 10 kHz in repetition frequency. For a varying number (n = 5-70) of focal plane additive pulse layers (14 groups, three repetitions each), two-dimensional scanning and ablation were performed on the dentin regions of the tooth sample slices, which were fixed on the focal plane. The ablation depth, d, was measured, and the quantitative function between n and d was established. Six slices were used in the second section. The function was used to calculate and set the timing of stepwise increments, and the single-step size along the focal plane normal was d micrometer after ablation of n layers (n = 5-50; 10 groups, six repetitions each). Each sample underwent three-dimensional scanning and ablation to produce 2 × 2-mm square cavities. The difference, e, between the measured cavity depth and theoretical value was calculated, along with the difference, e 1, between the measured average ablation depth of a single-step along the focal plane normal and theoretical value. Values of n and d corresponding to the minimum values of e and e 1, respectively, were obtained. In two-dimensional ablation, d was largest (720.61 µm) when n = 65 and smallest when n = 5 (45.00 µm). Linear regression yielded the quantitative relationship: d = 10.547 × n - 7.5465 (R (2) = 0.9796). During three-dimensional ablation, e 1 was the smallest (0.02 µm) when n = 5 and d = 45.00 µm. The depth error was 1.91 µm when 450.00-µm depth cavities were produced. When ablating dentin with a three-axis picosecond laser scan-ablation device (450 µm, 3 W, 10 kHz), the number of focal plane additive pulse layers and step size along the focal plane normal was positively correlated with the single-layer and total ablation depth errors. By adjusting the timing of stepwise increments along the focal plane normal and single-step size when ablating dentin by using the numerically controlled picosecond laser, the single-step ablation depth error could be controlled at the micrometer level.

An automatic robotic system for three-dimensional tooth crown preparation using a picosecond laser.

BACKGROUND: Laser techniques have been introduced into dentistry to overcome the drawbacks of traditional treatment methods. The existing methods in dental clinical operations for tooth crown preparation have several drawbacks which affect the long-term success of the dental treatment. OBJECTIVE: To develop an improved robotic system to manipulate the laser beam to achieve safe and accurate three-dimensional (3D) tooth ablation, and thus to realize automatic tooth crown preparation in clinical operations. METHOD: We present an automatic laser ablation system for tooth crown preparation in dental restorative operations. The system, combining robotics and laser technology, is developed to control the laser focus in three-dimensional motion aiming for high speed and accuracy crown preparation. The system consists of an end-effector, a real-time monitor and a tooth fixture. A layer-by-layer ablation method is developed to control the laser focus during the crown preparation. Experiments are carried out with picosecond laser on wax resin and teeth. RESULTS: The accuracy of the system is satisfying, achieving the average linear errors of 0.06 mm for wax resin and 0.05 mm for dentin. The angle errors are 4.33° for wax resin and 0.5° for dentin. The depth errors for wax resin and dentin are both within 0.1 mm. The ablation time is 1.5 hours for wax resin and 3.5 hours for dentin. CONCLUSIONS: The ablation experimental results show that the movement range and the resolution of the robotic system can meet the requirements of typical dental operations for tooth crown preparation. Also, the errors of tooth shape and preparation angle are able to satisfy the requirements of clinical crown preparation. Although the experimental results illustrate the potential of using picosecond lasers for 3D tooth crown preparation, many research issues still need to be studied before the system can be applied to clinical operations.

Preliminary study on a miniature laser manipulation robotic device for tooth crown preparation.

BACKGROUND: The existing methods in dental clinical operations for hard tissue removal have several drawbacks which affect the long-term success of the dental treatment. METHODS: In this paper, we introduce a miniature robotic device called LaserBot, which can manipulate a femtosecond laser beam to drill/burr a decayed tooth to realize clinical tooth crown preparation. In order to control the 3D motion of the laser focal point on the surface of a tooth, three miniature voice-coil motors with optical grating rulers are utilized to drive the 2D pitch/yaw rotation of a vibration mirror and 1D translation of a protruding optical lens. This method can provide high-resolution control of the laser beam. In order to maintain the small size of the robot, a parallel five linkage mechanism combined with a slider-rocker mechanism is developed to realize 2D pitch/yaw rotation of the vibration mirror. RESULTS: Experiment results show that the movement range and resolution of the laser beam point can meet the requirement of typical dental operations. The size of the working end of the device that enters the mouth is 25 × 22 × 57 mm (height × width × length), which is small enough to be mounted on any tooth. The average repeatability error of the laser focal point is about 40 µm. Ablation experiments on wax-resin material and on tooth validate that a femtosecond laser can be used for tooth ablation. CONCLUSIONS: The developed robotic device achieved precise 3D motion control of a laser focal point and is small enough to be used in the narrow workspace of the oral cavity. Limitations of the prototype have been identified, and quantified specifications are identified for designing the next generation prototype.