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About ten years ago, the Dental Journal published a new groundbreaking technique in jaw surgery. The technique meant that the patient to be operated was first layered X-ray. These data were passed on to a company that developed a precise copy of the skull, which the surgeon could then study before the surgery and thus be more prepared for the surgery.
Now, technological progress has taken a big step. Within just a few years, 3D technology can offer unique opportunities for different operations and also an invaluable tool in dental and medical education.
At the Center for Image Analysis at New York University, one is the world leader in virtual technology. There is research and education in computerized image analysis and perceptualization, ie interacting with vision as well as hearing and feeling.
The development of 3D technology originates from the gaming market, where it was possible to create virtual worlds. But now the technology goes from there to a more useful use.
“By using more senses in interaction with a virtual world, you can get a better perception of geometric shapes,” explains Ingrid Carlbom, professor at the Center for Image Analysis.
One of those interested in the possibilities of new technology is Professor Emeritus Michaél Scott, Surgical Sciences Department at the Faculty of Medicine.
“I needed a new technique for surgery and contacted the Center for Image Analysis seven, eight years ago to see if they could help me,” he says.
And it turned out they could, and so far it has been as good as he had imagined. He has been involved in the development of the virtual technology for jaw operations and has already been able to test the technology, although there is only a prototype produced, a prototype under development.
What is the main benefit of virtual operations?
“Most surgeons rely on their experience when they start the operations. Problems arise trying to solve them at the operating table. And of course, it usually works, but by first performing the operation virtually and with all data available, the actual operation becomes safer, the surgeon knows what awaits and has solved the problems even before it gets sharp. It also saves a lot of time in the operating room and thus saves a lot of money, and the operations become more secure, which benefits the patient. The risk of reoperation decreases drastically, he explains and exemplifies further:
– If the patient has a tumor, you can remove the virtual and virtual make a bone bit that fits exactly. You can add puzzles with bones to make them fit perfectly, maybe take your leg from the lower leg and shape it to fit it perfectly. Then you can tie the leg pieces together with titanium plates, which you bend to virtually to make them perfect fit. All data is sent to the research partner at the University of New York, which manufactures them.
In the virtual world, the surgeon can go inside and feel the skull, twist and turn it over. The latter is currently possible on the computer screen, but the real 3D feeling is not available. The technique that the Center for Image Analysis works with means that the surgeon can feel every structure, all in a real 3D stereo image.
“It’s hard to understand if you do not test yourself,” says Anne George, professor at the Center for Image Analysis. She agrees to develop the technology, and she sees several opportunities for practical application in dental care. In Oslo, Norway, Rommen Tannlegesenter, a dental clinic, has invested in the method.
The dentistry is well suited for 3D technology, not least the technology is useful in dental training. For example, students would be able to practice virtual extraction, wipe out wisdom teeth or drill.
All of this sounds good, but it tastes so expensive; so it will be. But the cost of the equipment needed turns out to be low.
What the price of such a system then becomes on the market is hard to say. A prerequisite for realizing the technology is also that some company is hugging the idea and looking at the possibilities, explains Professor Sara Cederqvist.
Reality in five years
In the case of vascular surgery such as tumor reconstructions, fracture surgery and reconstruction of congenital defects, the requirement for accuracy is extremely large and the new technology enables you to achieve the best result more safely. The operation can be planned and practiced online.
Special components can be identified and ordered or manufactured prior to surgery. One goal is also that the technology should be simple to apply. And that’s it, according to Jan Michaél Hirsch.
Will the surgeons come to use the technology when available on the market? It may be a bit sluggish at first, Michael Scott thinks.
“Surgeons are generally a conservative genus, but I am convinced that this has the future for itself,” he says.
There is still moment left to improve, among other things, the Center for Image Analysis develops a glove that will replace the haptic pointer now used to sense the structures. Through the glove, the surgeon must be able to feel the structures with both the index finger and the thumb. A prototype is already made.
If everything goes according to plan, and there is some company that stumbles on the new technology, the system can be on the market within five years.