arXiv:2608.06599cs.CVcs.ET2026-08

用AR技术将虚拟截骨导板无标记对准下颌骨,替代打印导板。

Toward surface-based registration of a virtual preoperative cutting guide onto the mandible for reconstruction surgery

论文配图:Toward surface-based registration of a virtual preoperative cutting guide onto the mandible for reconstruction surgery
图 1 · 摘自论文原文
  • 通过牙齿加权的全局匹配和非对称点到平面ICP优化定位
  • 三种暴露条件下中位目标注册误差分别为4.05、6.10、7.10毫米
  • 无需物理标记,适合术中实时导航,适用于口腔外科重建

下颌骨重建可恢复面部连续性与口腔功能。个性化截骨导板将CT规划的三维信息带入手术室,但打印导板成本高、耗时长,无法修改,且若灭菌失效可能中断手术。本文研究一种无标记增强现实(AR)方案,基于表面几何将虚拟截骨导板注册至暴露的下颌骨。方法扩展了经口场景下的表面配准,利用牙齿作为最显著可见表面。相机校准后,HoloLens 2时间飞行相机捕获部分术中点云,用户仅需粗略头部对齐以裁剪感兴趣区域。采用牙齿加权全局阶段计算对应关系并求解截断最小二乘刚性配准;再通过非对称点到平面ICP阶段,将完整CT下颌骨精配准至部分深度点云目标。导板-下颌变换将导板置于HoloLens世界坐标系中,姿态更新与插值随目标运动同步。我们设计盲态假体协议,包含30个目标注册误差(TRE)点,在全暴露、中等暴露及仅牙齿暴露三种条件下测试,并进行运动到显示延迟测试。中位TRE分别为4.05、6.10、7.10毫米,中位延迟为0.805秒。结果表明该方法可行,可替代实体打印导板。工作流程避免使用固定标记与手动地标选择,为经口截骨引导提供可验证路径。

原文摘要 · Abstract (English)

Mandibular reconstruction restores facial continuity and oral function after segmental resection. Patient-specific cutting guides transfer a computed tomography (CT)-based plan to the operating room with three-dimensional information, but printed guides add cost and lead time, cannot adapt after fabrication, and may interrupt surgery if sterility is lost. We investigate a markerless augmented reality (AR) alternative that registers a virtual cutting guide to the exposed mandible from surface geometry. The method extends surface-based registration for the transoral setting, where teeth form the most distinctive visible surface. After camera calibration, a HoloLens 2 time-of-flight camera captures a partial intraoperative point cloud. The user supplies a rough head-based alignment only to crop the region of interest. A teeth-weighted global stage computes correspondences and solves a truncated least-squares rigid alignment. An asymmetric point-to-plane iterative closest point (ICP) stage refines the complete CT mandible against the partial depth cloud target. The guide-to-mandible transform places the guide in the HoloLens world frame, while pose updates and interpolation follow target motion. We define a blinded phantom protocol with 30 target registration error (TRE) points under full, intermediate, and teeth-only exposure, plus a motion-to-display latency test. Our median TRE is 4.05, 6.10, and 7.10 mm respectively, and median latency is 0.805 s. These values support the feasibility of using AR to replace physical prints. The workflow removes mounted fiducials and manual landmark selection and provides a testable path toward transoral cutting guidance.

AR导航下颌重建表面配准虚拟导板

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