研發雙機器臂動態導航系統應用於引導式根管治療：精準度與效率之評估

Abstract

目前市售的動態導航系統多採用光學感測技術，然其仍存在光源穩定性不足、感測元件易受環境光干擾，以及感測器或光學配件容易被遮蔽等限制。為克服光學導航的不足，本研究旨在探討整合雙機器手臂系統之導引技術於根管定位與模擬臨床操作中的精準性、流程效率與臨床可行性。 本研究依據診間空間配置與臨床需求，設計並建置雙機器臂導航系統原型，並開發整合式軟體平台，將小範圍CBCT影像與口內掃描資料進行整合與對位，進行影像對位流程最佳化建置。接著，完成術前治療計畫擬定後，即可透過雙機器臂系統執行導航導引計畫。此外，本研究亦針對整體操作流程與註冊時間，將本系統與市售X-Guide光學動態導航系統進行比較，以評估其操作效率與定位精準度。在系統精準度驗證方面，於模型中比較術前治療計畫與實際鑽孔軌跡之間於尖端位置及鑽孔角度的誤差，以驗證其導航準確性。 本研究所開發之雙機器臂導航系統原型依照臨床空間配置設計，裝置尺寸為46 × 57 × 79 cm3，整合兩組三次元量測臂，系統校正誤差為0.152 mm。開發的非手術性根管治療規劃軟體可支援多種CBCT 參數組合，整合CBCT 影像與口掃模型，實現高效影像對位流程。影像對位平均誤差為0.088 mm，優於僅使用CBCT的對位誤差0.253 mm。註冊流程方面，系統平均耗時66.6 秒，較X-Guide 光學動態導航系統的111.07 秒快，效率提升66.62%。在導航精度驗證中，於以真牙模型複製的3D 列印模型中進行20 個根管鑽孔計畫，尖端位置平均誤差為0.595 mm，角度誤差為1.230°，均優於X-Guide 系統，證實本系統具備優異的定位精準性與臨床可行性。 本研究成功研發一套具臨床應用潛力的雙機器臂動態導航系統，系統具備高精度、高效率與良好臨床整合性，為牙科精準導航技術提供一項創新、可行的解決方案。

Current dynamic navigation systems predominantly rely on optical sensing technologies, which encounter challenges such as unstable lighting, ambient light interference, and sensor occlusion. This study evaluates a novel dual robotic arm navigation system designed for root canal localization, with emphasis on its accuracy, efficiency, and clinical applicability. A prototype system was developed to accommodate clinical spatial constraints, incorporating custom software that aligns small field-of-view CBCT data with intraoral scans to enhance image registration. Following preoperative planning, the robotic system executes the navigation procedure. Its registration time and workflow efficiency were compared to those of the commercial X-Guide system, while accuracy was assessed using 3D-printed models by measuring deviations between planned and actual drilling paths. The system measures 46 × 57 × 79 cm3 and integrates two 3D measurement arms, achieving a calibration error of 0.152 mm. The software supports various CBCT parameters and effectively fuses CBCT and intraoral scan data. The average image registration error was 0.088 mm, significantly improving upon CBCT-only registration at 0.253 mm. Registration time averaged 66.6 seconds, representing a 66% improvement over the X-Guide’s 111.07 seconds. Accuracy tests demonstrated an average apical deviation of 0.595 mm and angular error of 1.230°, both outperforming the X-Guide system. In conclusion, this study successfully developed a dual-arm dynamic navigation system that offers high accuracy and efficiency, providing an innovative and practical solution for guided endodontics.