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Accuracy of augmented reality-assisted vs. template-guided apicoectomy - An ex vivo comparative study.

AIM
The aim of this ex vivo study was to examine the accuracy of apicoectomies performed by means of augmented reality-assisted (AR-A) versus template-guided apicoectomies (TG-A).


MATERIAL AND METHODS
In total, 40 apicoectomies were performed in 10 cadaver pig mandibles. Every pig mandible underwent two template-guided apicoectomies (TG-A) and two AR-assisted apicoectomies (AR-A) in molar and premolar teeth. A crossed experimental design was applied. AR-A was performed using the Microsoft Hololens 2. TG-A was performed using the SMOP software. Postoperative cone beam CT scans were superimposed with the presurgical planning data. The deviation between the virtually planned apicoectomy and the surgically performed apicoectomy was measured. The angular deviation (primary outcome; [degree]) and the depth deviation (secondary outcome; [mm]) was measured.


RESULTS
Overall 36 out of 40 apicoectomies could be included in the study. Regarding the primary outcome parameter, angle deviation, there was no significant difference between AR-A and TG-A. The mean values were 5.33° (± 2.96°) in the AR-assisted group and 5.23° (± 2.48°) in the template-guided group. The secondary outcome parameter depth deviation showed no significant difference between the AR-assisted group of 0.27mm (± 2.32mm) and the template-guided group of 0.90mm (± 1.84mm). In this crossed experimental design, both techniques showed to overshoot the target depth in posterior sites versus not reaching target depth in anterior sites (p<0.001).


CONCLUSION
AR technology has the potential to be introduced 27 into apicoectomy surgery, in case further development is implemented.