It wouldn’t seem a dentist could get lost in a patient’s mouth during oral surgery. But dentistry is complicated–so it happens.
Doron Dekel, CEO and co-founder of Toronto-based ClaroNav, a pioneering dental navigation company, said, “Many different complications can occur. Dentists, for instance, can hit the roots of nearby teeth, if they are drilling near an existing tooth and the root is angled slightly diagonally. Or the dentist can hit the nerve that goes through the jaw and then can paralyze half the face for six months or permanently.”
ClaroNav developed software and hardware for its Navident system to provide real-time data to dentists to steer clear of these problems. Navident has been on the market in the U.S. since September 2016 and in Canada, Europe and Asia since 2015. The main purchasers of the $25,000 systems are oral and maxillofacial surgeons, high-volume general dentists, prosthodontists and periodontists.
From Neurosurgery to Dentistry
Before launching ClaroNav in 2010, Dekel and co-founder Claudio Gatti worked for a manufacturer of a neurosurgery navigation system. They decided to apply the idea to dentistry. They came up with a 25-kilogram system on wheels with lighting and an arm holding a laptop linked with data from a CBCT [cone beam CT] scan, a special type of scanner for dentistry.
Navident will tell you where you are on that map
Dekel said Navident is a GPS-like system where a CBCT scan of a patient’s mouth creates a 3-D map of the patient’s anatomy. “When you move instruments in the anatomy, Navident will tell you where you are on that map,” he said.
The dental surgeon plans where implants should be placed in the image. Navident dynamically tracks the drill and the patient’s jaw, providing guidance and visual feedback to ensure the implants are placed according to plan, Dekel said.
During the surgery, the dentist looks at the video monitor on a 13- or 15-inch laptop which magnifies the teeth by a factor of 20 times.
0.5 Millimeters Accuracy
Dekel said dentists using his guidance system have an average accuracy of about 0.5 millimeters compared with 2.5 millimeters for dentists not using a guidance system.
Dentists as well as patients experience major benefits from the system.
“Navident is less invasive than traditional surgery. You don’t have to cut open the gums to expose the bone. Incisions obviously increase the pain and the bleeding and the risk of infection,” said Dekel. “They also increase the time of surgery and put stitches in the mouth which are uncomfortable for the patient.”
You don’t have to cut open the gums to expose the bone.
Enhancements have been added to the system. Dekel said the company’s ClaroScope is a new HD camera enabling the surgeon to zoom in on the area where he or she is working.
Other dental navigation companies include Eped Inc. in Taiwan, X-Nav Technologies in Lansdale, Pennsylvania and Inliant Surgical in Vancouver, Canada.