Accuracy and safety of dynamic navigation combined with augmented reality for multiple-site implant surgery: a case report

Abstract This case report presents a method for integrating multi-screen imaging information using an augmented reality-assisted dynamic navigation (AR-DN) system in multiple-site implant surgery with limited bone height. The case presented is a 22-year-old female with reduced masticatory function due to partial edentulism in the left mandibular posterior region. Preoperative CBCT revealed limited residual bone height above the inferior alveolar nerve canal at the sites corresponding to the second premolar and first molar. To tackle the challenges of sequential multiple implant placements in areas with limited bone height, an augmented reality-assisted dynamic navigation (AR-DN) system was employed. This system integrated the dynamic navigation interface, CBCT imaging, and preoperative implant site planning, displaying them simultaneously in the surgeon’s field of view. This setup offered real-time guidance to the surgeon, eliminating the necessity to shift focus between the navigation screen and the surgical site, enhancing hand-eye coordination, and streamlining intraoperative decision-making. Three implants were consecutively placed, with an average global deviation of 0.92 ± 0.36 mm, an apex deviation of 0.88 ± 0.44 mm, and an angular deviation of 3.02° ± 0.77°. No complications were observed during the operation and postoperative follow-up period. The AR-DN system enabled safe and accurate sequential placement of multiple implants within areas of limited bone height by providing real-time visual guidance. However, further clinical trials are needed to confirm its broader applicability.