Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study

The objective of the present study was to evaluate and compare the accuracy of the computer-aided static navigation technique (NAV), augmented reality (AR) and freehand placement technique (FHT) for the bicortical orthodontic self-drilling mini-implants for maxillary skeletal expansion (MSE) applian...

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Main Authors: Giovanni Giovannini Riso, Javier Flores-Fraile, Gianmarco Perrone, Georgia Tzironi, Ana Belén Lobo Galindo, Cosimo Galletti, Álvaro Zubizarreta-Macho
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Bioengineering
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Online Access:https://www.mdpi.com/2306-5354/12/7/703
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author Giovanni Giovannini Riso
Javier Flores-Fraile
Gianmarco Perrone
Georgia Tzironi
Ana Belén Lobo Galindo
Cosimo Galletti
Álvaro Zubizarreta-Macho
author_facet Giovanni Giovannini Riso
Javier Flores-Fraile
Gianmarco Perrone
Georgia Tzironi
Ana Belén Lobo Galindo
Cosimo Galletti
Álvaro Zubizarreta-Macho
author_sort Giovanni Giovannini Riso
collection DOAJ
description The objective of the present study was to evaluate and compare the accuracy of the computer-aided static navigation technique (NAV), augmented reality (AR) and freehand placement technique (FHT) for the bicortical orthodontic self-drilling mini-implants for maxillary skeletal expansion (MSE) appliances placed in palate. <b>Material and Methods</b>: A total of 120 bicortical orthodontic self-drilling mini-implants were placed in the palate of ten 3D printed anatomically based polyurethane models of a completely edentulous upper maxilla. The orthodontic mini-implants were randomly assigned to the following placement techniques: (A) computer-aided static navigation technique (<i>n</i> = 40) (NAV), (B) augmented reality device (<i>n</i> = 40) (AR) and (C) conventional freehand technique (<i>n</i> = 40) (FHT). Moreover, two implants were placed in each side of the midpalatal suture in every model according to the digital planification of the expander device. Subsequently, the orthodontic mini-implants were placed and postoperative CBCT scans were performed. Finally, coronal entry-point (mm), apical end-point (mm) and angular deviations (°) were calculated using a <i>t</i>-test. <b>Results</b>: Statistically significant differences were shown at coronal entry-point (<i>p</i> < 0.001), apical end-point (<i>p</i> < 0.001) and angular deviations (<i>p</i> < 0.001) between the three placement techniques of bicortical orthodontic mini-implants. Additionally, statistically significant differences were also shown between the orthodontic mini-implant positions concerning the entry point (<i>p</i> = 0.004) and angular deviation (<i>p</i> = 0.004). <b>Conclusions</b>: The augmented reality placement technique results are more accurate, followed by the computer-aided static navigation technique and the freehand technique for MSE appliances placed in palate.
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spelling doaj-art-166f1e05c3ba414dbe4c058804e48d2e2025-08-20T03:13:37ZengMDPI AGBioengineering2306-53542025-06-0112770310.3390/bioengineering12070703Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro StudyGiovanni Giovannini Riso0Javier Flores-Fraile1Gianmarco Perrone2Georgia Tzironi3Ana Belén Lobo Galindo4Cosimo Galletti5Álvaro Zubizarreta-Macho6Faculty of Dentistry, Alfonso X el Sabio University, 28691 Madrid, SpainDepartment of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, SpainFaculty of Dentistry, Alfonso X el Sabio University, 28691 Madrid, SpainDepartment of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, SpainDepartment of Surgery, Faculty of Medicine and Dentistry, University of Salamanca, 37008 Salamanca, SpainFaculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, ItalyFaculty of Dentistry, Alfonso X el Sabio University, 28691 Madrid, SpainThe objective of the present study was to evaluate and compare the accuracy of the computer-aided static navigation technique (NAV), augmented reality (AR) and freehand placement technique (FHT) for the bicortical orthodontic self-drilling mini-implants for maxillary skeletal expansion (MSE) appliances placed in palate. <b>Material and Methods</b>: A total of 120 bicortical orthodontic self-drilling mini-implants were placed in the palate of ten 3D printed anatomically based polyurethane models of a completely edentulous upper maxilla. The orthodontic mini-implants were randomly assigned to the following placement techniques: (A) computer-aided static navigation technique (<i>n</i> = 40) (NAV), (B) augmented reality device (<i>n</i> = 40) (AR) and (C) conventional freehand technique (<i>n</i> = 40) (FHT). Moreover, two implants were placed in each side of the midpalatal suture in every model according to the digital planification of the expander device. Subsequently, the orthodontic mini-implants were placed and postoperative CBCT scans were performed. Finally, coronal entry-point (mm), apical end-point (mm) and angular deviations (°) were calculated using a <i>t</i>-test. <b>Results</b>: Statistically significant differences were shown at coronal entry-point (<i>p</i> < 0.001), apical end-point (<i>p</i> < 0.001) and angular deviations (<i>p</i> < 0.001) between the three placement techniques of bicortical orthodontic mini-implants. Additionally, statistically significant differences were also shown between the orthodontic mini-implant positions concerning the entry point (<i>p</i> = 0.004) and angular deviation (<i>p</i> = 0.004). <b>Conclusions</b>: The augmented reality placement technique results are more accurate, followed by the computer-aided static navigation technique and the freehand technique for MSE appliances placed in palate.https://www.mdpi.com/2306-5354/12/7/703orthodonticsmini-implantspalatal expansionmaxillary expansionmaxillary skeletal expansioncomputer-aided navigation
spellingShingle Giovanni Giovannini Riso
Javier Flores-Fraile
Gianmarco Perrone
Georgia Tzironi
Ana Belén Lobo Galindo
Cosimo Galletti
Álvaro Zubizarreta-Macho
Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
Bioengineering
orthodontics
mini-implants
palatal expansion
maxillary expansion
maxillary skeletal expansion
computer-aided navigation
title Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
title_full Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
title_fullStr Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
title_full_unstemmed Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
title_short Evaluation of Computer-Aided Navigation and Augmented Reality for Bicortical Mini-Implant Placement in Maxillary Expansion: An In Vitro Study
title_sort evaluation of computer aided navigation and augmented reality for bicortical mini implant placement in maxillary expansion an in vitro study
topic orthodontics
mini-implants
palatal expansion
maxillary expansion
maxillary skeletal expansion
computer-aided navigation
url https://www.mdpi.com/2306-5354/12/7/703
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