Medical radiography is the use of radiation to “see through” a human body without breaching its integrity (surface). With
computed tomography (CT)/cone beam computed tomography (CBCT), three-dimensional (3D) imaging can be
produced. These imagings not only facilitate disease diagnosis but also enable computer-aided surgical
planning/navigation. In dentistry, the common method for transfer of the virtual surgical planning to the patient (reality)
is the use of surgical stent either with a preloaded planning (static) like a channel or a real time surgical navigation
(dynamic) after registration with fiducial markers (RF). This paper describes using the corner of a cube as a radiopaque
fiducial marker on an acrylic (plastic) stent, this RF allows robust calibration and registration of Cartesian (x, y, z)-
coordinates for linking up the patient (reality) and the imaging (virtuality) and hence the surgical planning can be
transferred in either static or dynamic way. The accuracy of computer-aided implant surgery was measured with
reference to coordinates. In our preliminary model surgery, a dental implant was planned virtually and placed with
preloaded surgical guide. The deviation of the placed implant apex from the planning was x=+0.56mm [more right], y=-
0.05mm [deeper], z=-0.26mm [more lingual]) which was within clinically 2mm safety range. For comparison with the
virtual planning, the physically placed implant was CT/CBCT scanned and errors may be introduced. The difference of
the actual implant apex to the virtual apex was x=0.00mm, y=+0.21mm [shallower], z=-1.35mm [more lingual] and this
should be brought in mind when interpret the results.
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