A Novel Lightweight Navigation System for Oral and Maxillofacial Surgery Using an External Curved Self-Identifying Checkerboard

This paper presents a novel lightweight navigation system for oral and maxillofacial surgery (OMS). An external curved checkerboard with self-identifying markers is set as the reference object around the surgical scene. A customized oral clip with a micro camera is designed for oral localization by tracking the external checkerboard. Similarly, the dental handpiece is also equipped with a micro camera, which can be localized like the clip. The spatial model of the markers is provided by binocular stereoscopic reconstruction. A front surface mirror is taken up for the registration between the oral cavity and the camera on the clip. The pivot calibration of the dental handpiece is accomplished by our proposed calibration method. We set up an experimental group and a control group for evaluation. The surgical tools of the experimental group were approximately 30% lighter, 35% less bulky, and 90% cheaper than those of the control group. Our system yielded the comprehensive navigation accuracy of 0.92 mm whereas the accuracy of the control group was 0.87 mm. Results revealed that our system can achieve similar accuracy compared with a prevailing system at a lighter weight, a more compact volume, and a lower cost. Note to Practitioners —The motivation of this work is to reduce the burden on patients and surgeons during OMS. Current commercial navigation systems are still limited by the burden of extra cumbersome fiducial markers and high hardware costs. Their high accuracy benefits from the large size of fiducial markers. To take full advantage of the camera’s localization effect, we propose the concept of “marker-camera inverse projection”, i.e., reversing the roles of the camera and the markers. In this way, cameras on surgical tools detect more points with a more uniform distribution. Our proposed system achieves a decent balance between navigation accuracy and hardware cost, which facilitates the development of surgical tools to be lighter and more economical, and involves tremendous potential for commercialization.