G.A. Adersh,L.K. Surej Kumar,S. Sibi,Roshan John,N.S. Divya
‘SRISTI’ (software reconstruction and implant synthesis from tomographic images); three dimensional reconstruction software for dentistry
3d reconstruction,Digital imaging,Software,Implant planning,Simulation
‘SRISTI’ (software reconstruction and implant synthesis from tomographic images); three dimensional reconstruction software for dentistry

Revolutionary ability of computer applications for reconstruction of tomographic images has proven to be valuable aid for planning and executing complex surgeries. These softwares help in prototyping any human organs and literally the planned surgeries can be mocked with the 3D printed models. In dentistry 3D reconstruction helps in diagnosis, treatment planning, performing mock surgeries, implant simulation, creating surgical guides, making prosthetics and even in forensic odontology. Most of the softwares come along with their respective tomographic machines. Open source softwares for educational purposes are available for reconstruction. Most of the 3D reconstruction and implant planning softwares are so expensive and cannot be used routinely for all patients so we made a similar software with open source support for educational and research purposes.

Our aim was to create a 3D reconstruction software which can help in diagnosis and simulation of all the dental procedures and other general surgical procedures to some extend. Initially in version 1.1 we added implant simulation along with the reconstruction module. We did the coding with a commonly used language and its compiler. We have added digital libraries of many open source commercially available implant systems.

We planned for a black and gold theme with multiple tool bars. The first toolbar includes the basic drop down menu buttons (Fig. 1). The second tool bar below the first one was used by shortcut icons for opening the files, loading the tomographic images, orienting the constructed structures in multiple planes and measuring tools. A black field with 75% screen space was used for viewing the reconstructed images (Fig. 2). Right side menu bar with 20% screen space was created for surface and volume rendering along with segmentation tools. Toggle switches for clipping the constructed structures in coronal, axial and sagittal planes were also designed in the right side menu bar.

Primarily it can be used for 3D reconstruction of the tomographic images and the 3D structures can be exported into 3D printable file formats (Fig. 3) with extensions (.stl and. obj). It has got an interactive manual segmentation tool which can help to add any missing layers in the constructed tomographic image (Fig. 4). Next we added dental implant libraries of commercially available dental implants for implant planning and simulation.

Tomographic planes produced by the machines are usually saved as DICOM (Digital Imaging and Communications in Medicine) images. The same DICOM images are then opened in the software. After selecting the files, volume rendering or surface rendering can be done by selecting the respective buttons. After rendering the images reconstructed files can be converted to the 3D printable formats.

We are constantly modifying the software by adding many features. We are giving the software with all features through an online platform. Researchers can use a link (http://3.134.118.120:8080/CloudImgService/) for online access. Prior to getting access to the link, a request has to be sent to the developers via the following mail address: sibis@cdac.in. This web page will ask to upload the DICOM images. After uploading you can use the software.

We are constantly modifying the software with added functions, we are adding the simulation tools for orthognathic and reconstruction surgeries. We are also planning for a virtual and augmented reality projects added to the same software pre clinical training for the students.

The development of a new toolkit for medical imaging was a tedious task. Even though there are many open source toolkits available, they can only be used for imaging and diagnosis. Development of a toolkit for simulation of procedures need more complex interactive visual datasets. SRISTI software has some glitches. We have to add many versatile imaging formats other than DICOM in our software. Also we have got problems with DICOM images which were available in multiple series. In some cases, surface rendering was not proper (Fig. 5). We tried to rectify it by adding manual segmentation feature.

SRISTI is our first initiative to open up the most advanced diagnostics, virtual treatment planning and simulation system to the research enthusiasts who are really interested in the futuristic dentistry.

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