Real-time augmented reality-guided insertion of interradicular orthodontic mini-implants for functional occlusal management: A preclinical validation of accuracy and subjective influence.

OBJECTIVE

Accurate placement of interradicular mini-implants is a critical biomechanical prerequisite for correcting malocclusion and restoring oral function, but avoiding root damage remains challenging for novice clinicians. While augmented reality (AR) offers a potential solution, existing studies often rely on strict zero-deviation criteria and lack subjective evaluation. This study aimed to assess the objective accuracy and subjective impact of a real-time AR guidance system for placing interradicular mini-implants in three-dimensional-printed models.

METHODS

Twelve customized 3D-printed maxillary and mandibular models were fabricated. An AR-guidance platform was developed using an object-recognition registration method. Six novice clinicians performed 216 simulated mini-implant insertions using either the freehand or AR-guided method with a randomized crossover design. Outcomes included objective indices (angular and linear deviations from clinically defined safe ranges, iatrogenic complication rates, and procedural time) and subjective indices (self-reported confidence and competency).

RESULTS

The AR-guided group demonstrated fewer deviations in the mesio-distal (P<.001) and the corono-apical angulation (P<.001) compared to the freehand group. Vertical positioning accuracy was also superior in the AR-guided group (P<.001). Furthermore, AR guidance reduced iatrogenic complication rates (P<.05) while enhancing participants' self-confidence and perceived competency (P<.001). The insertion time exhibited no difference between groups (P > .05).

CONCLUSIONS

The developed AR system improved the accuracy and safety of inserting interradicular orthodontic mini-implants by novice clinicians. By enhancing operator acceptability and confidence, this low-cost workflow demonstrates translational potential for digital orthodontics in the precise management of functional occlusion.

CLINICAL SIGNIFICANCE: The developed AR system for placing interradicular orthodontic mini-implants is an effective navigation tool and a solution to enhance confidence of novice clinicians, ensuring the safe clinical execution of digital functional occlusal setups.