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Journal of Mechanics Engineering and Automation 1 (2011) 331-341

Dental Arch3D Direct Detection System from the

Patients Mouth and Robot for Implant Positioning
Paola Nudo
, Michele Perrelli
, Mario Donnici
, Guido Danieli
, Francesco Inchingolo
, Francesco Giuzio
Massimo Marrelli

1. Department of Mechanic, Engineering, University of Calabria, Arcavacata Rende 87036, Italy
2. Department of Dentistry, Faculty of Medicine, University of Bari, Bari 70100, Italy
3. Dentists Office, Cosenza 87100, Italy
4. Dentalia S.r.L, Crotone 88900, Italy

Received: September 09, 2011 / Accepted: September 29, 2011 / Published: October 25, 2011.

Abstract: This paper describes a three-dimensional structured light scanning system to generate a virtual model of a dental arch, from
the patients mouth, and the scheme of a 2 + 1 DOF (degree of freedom) parallel/serial Robot for implant positioning, both positioned
on a platform held in a fixed position with respect to the patients head. Presently, dental prosthesization requires quite a long time to be
completed. This process, in fact, involves the detection of the shape of the dental arch, its plaster model generation, scanning of it,
prosthesis preparation and its implant. The procedure is even longer when use of dental implants is required, while early loading of the
implants is considered a positive solution. Current research effort is focused on the development of devices for the direct intra-oral
determination of the shape of dental prostheses and inserts. These devices, however, are able to detect limited portions of the dental
arch, since they must be hand-held by the doctor without external supports, and this may produce relatively large errors due to the sum
of relatively small ones. Furthermore, to place an implant correctly, the doctor can use a new system to guide the implant position, but
this requires sending the information in Sweden to obtain a special mask in return.

Key words: Calibration, stereovision, structured light.

1. Introduction
During the last years, three-dimensional scanning
technologies have evolved rapidly. Several digitizing
systems have been proposed which can be divided into
two main categories: contact systems and non-contact
systems [1]. The contact systems digitize a surface by
means of a mechanical digitizer, so that the acquisition

Michele Perrelli, Ph.D. student, research field: electronics
and robotics.
Mario Donnici, Ph.D. student, research field: biomedical.
Guido Danieli, full professor, research field: applied
Francesco Inchingolo, associate professor, research field:
Francesco Giuzio, dentist, research field: oral surgery.
Massimo Marrelli, medical director, research field: oral
Corresponding author: Paola Nudo, Ph.D., research field:
applied mechanics. E-mail:
time may be extremely long. The evolution of optical
sensors and optical devices allowed to development of
a new optical non-contact techniques. These methods,
which may dramatically reduce the acquisition time,
are divided in passive and active techniques. Passive
techniques do not require any additional energy source,
while active techniques require an auxiliary light
source. These systems are commonly used in
orthodontics to create Computer-Aided-Design (CAD)
models of the dental arch.
Nowadays, most dentists approach the process of
dental arch shape detection using a classic procedure,
which consists, at first, in the use of an impression
material to detect the shape of the patients dental arch
and, subsequently, in the creation of a dental cast from
the impression by means of dental stone. As a further
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning

step, the dental cast may be digitalized using different
shape acquisition methods to obtain a suitable virtual
model [2].
For many years researches have been trying to
improve this conventional process to minimize the
acquisition time and to optimize the final result, i.e., the
CAD model. The initial studies were concerned with
the use of intraoral probes, operating either by means of
a laser triangulation technique [3], or by a digitalized
projection pattern [4]. The main disadvantages are the
following: (a) the probes mechanical components are
not sterilizable and (b) the probe itself must be replaced
frequently, thus affecting the overall cost of the
procedure. In recent years, many studies were focused
on the development of new devices to reduce the
production costs and to automate the whole scanning
process [5]. Given the limited success of these
procedures, as a result, nowadays, dentists are provided
with specific mechanical or optical digitizers of
different types, which are able to scan the stone dental
arch and produce a virtual model of it.
In particular, some devices use topometric methods
or laser beam/structured light methods [6] to scan a
dental stone and obtain a CAD model of dental arch [7].
To improve the data acquisition process, new optical
devices were developed, as for instance, the Charside
Economical Restoration of Esthetic Ceramics (CEREC)
[8] or the 3M
system [9]. The camera is moved
manually in the patients mouth by the dentist. Being
the scanning process sensible to patients movement, in
the case of absence of such movements the
measurement accuracy in depth reaches up to 19 m.
With few exceptions, all these mechanical and optical
devices have hence a relatively high precision. On the
other hand some devices may be only used to scan the
dental stone; some others, as the intraoral digital device,
are sensitive to small movements of patient that could
compromise the quality of the final result. Currently, as
far as the authors are aware, no device is able to
automate the scanning process and eliminate the
manual scanning. This would dramatically reduce the
errors during the data acquisition process and eliminate
the impression phase and the use of the stone model.
This paper is concerned with the development of a
novel non-contact scanning system, which allows
obtaining the CAD model of the dental arch without the
use of an impression material, and thus directly from
the patients mouth.
This optical system, which uses a structured light
source and an optical sensor to acquire images, is based
both on the coded light technique and the epipolar
geometry principle. This system allows the suppression
of five steps in the classic procedure: (1) the material
application; (2) the material hardening; (3) sending the
impression; (4) casting the model; (5) scanning it.
After obtaining the CAD model of the dental arch, a
new system to guide the doctor in the placement of the
fittings in the oral cavity is needed. Presently dental
prosthesization using implants requires long times
between implant positioning and prosthesis fitting,
beside the problem of correctly positioning of the
implant where enough bone stock exists, and with the
correct inclination to support the load of mastication. It
is in fact necessary first to detect the shape of the dental
arch, then generate a plaster model, which is to be
scanned. On the base of this and of a Computet Axial
Tomography (CAT) or an orthopantomography the
doctor decides the optimal position of the implants and
proceeds manually. Only alternative to free hand
positioning, the use of Nobel Guide masks [10]. In this
case first the doctor, navigating through the CAT
virtual representation of the patients mouth,
establishes where to place the implants taking into
account the amount of bone stock available. Then these
information are sent to Nobel Guide, which returns the
mask which presents guiding holes where the implants
are to be positioned.
This paper describes also an implant positioning 2 +
1 degree of freedom (DOF) robotic system, which
should be combined with the 3D scanner, to guide the
doctor in the placement of the fittings in the oral cavity,
according to what previously decided from the exam of
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning

a CAT representation of the patient mouth.
The paper is organized as follows: Section 2
discusses the scanning system; section 3 introduces the
theory of camera and projector calibration; section 4 is
about the calibration results; section 5 introduces the
implant position; section 6 gives conclusions.
2. The Scanning System
The aim of this research is to develop an innovative
optical scanner which, using a particular coded light
technique, allows to obtain the CAD model of the
dental arch directly. The optical section of the scanner,
as shown in Fig. 1, is composed by a mini-projector
with a resolution of 800 600 pixels, two
micro-cameras with a resolution of 352 288 pixels
and a biconvex lens. This part of the scanner is located
on a planar moving system which is actuated by two
step motors via linear sliders.
The step motors are controlled by a microcontroller,
which allows to perform the automatic handling of the
linear sliders and to memorize the teeth positions.
Projector, lens and cameras locations are fixed to each
other, but movable with respect to the denture to be
examined, through a micrometric position control. A
tilting mechanism of the entire optical system is present
and a mirrors angular control will shortly be added as
well, in order to improve the detection ability of this
A six degree-of-freedom (DOF) self-balanced arm,
whose scheme is shown in Fig. 2, supports the whole
As can be noted in the figure, the plate on which the
system rests is suspended to the point in which at least
the last two rotational axes (5 and 6) meet. The weight
of the entire system is balanced by a counterweight, (11)
in the figure.
Thus, in order to avoid any disturbance to the patient,
the center of mass of whatever is placed on the plate
must coincide with the point of intersection between
the two last axes. But since the slides are present, than
two suitable sliding counterweights are also present,
driven by the motion of the slides, but in opposite

Fig. 1 Optical system.

Fig. 2 Scheme of the self-balanced arm.

direction. This detail is shown in the picture (Fig. 3).
Note also that this arrangement allows rotating the
entire plate by 180 when the upper dental arch is to be
The projector, lens and cameras system can also be
tilted in order to detect correctly the collar area of the
molars, and this is controlled rotating a small cam (the
blue element in Fig. 4).
The scanning system is kept in fixed position with
respect to the patients head through a suitable mask
resting on the vestibular area, fixed to a U shaped
external structure, secured with straps to a second
external structure pressing the chin (Fig. 5).
The mask provides a support for the miniaturized
detection system of the teeth shape. This latter can be
moved in a x-y plane within the oral cavity, allowing
the identification of the teeth position in terms of their
There are two phases of the process: during the first
phase the doctor, once positioned the mask in the
patients mouth, drives the system along the teeth to be
scanned, observing them through the cameras, so that
the device records the trajectory imposed by the doctor.
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning


Fig. 3 Sliding counterweights.

Fig. 4 Mechanism to tilt laterally the detecting device.

Fig. 5 Photo of the system used to block the patient.

In the second phase the control algorithm give the
signals needed to allow the intra-oral feature to enter
the patients mouth and move according to the
trajectory previously selected by the doctor. To allow
these movements, the microcontroller calculates the
optimal number of steps the motor has to rotate and the
direction of rotation.
During motion, the actual location is monitored by
the sensors and once the selected location is achieved,
its coordinates are memorized in order to be
post-processed by the software during reconstruction.
Finally, Fig. 6 shows the entire dental scanner.

Fig. 6 Dental scanner.
3. Theoretical Analysis of Calibration
In this work a new algorithm to obtain the dental
arch CAD model is developed. The method consists in
the calibration of the optical scanner and in the
subsequent scanning of the dental arch by means of
structured light, whereas a particular calibration
procedure is used to calculate the intrinsic parameters
of the projector.
This technique needs a mini-projector, two
micro-cameras b/n and two planar chessboard with
known size (Figs. 7a-7b). The micro-cameras have to
acquire two image sets to obtain the calibration
parameters. The camera calibration parameters are
used for the projector calibration.
Once the camera calibration parameters and
projector calibration parameters are obtained, the
optical scanner with the active triangulation method is
calibrated. The full calibration process is composed by
three steps:
(1) Camera calibration;
(2) Projector calibration;
(3) Scanner calibration.
Second counterweight
First counterweight
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning


(a) (b)
Fig. 7 Planar chessboard (a) for projector calibration (b)
for camera calibration.
3.1 Camera Calibration
All the micro-cameras are calibrated using the
classic methodology of indirect calibration [11]. The
parameters of the camera are obtained from the
correlation between a set of target points on a
calibration specimen, and the correspondent
coordinates in the image plane [12-13] (Fig. 8).
The calibration process is based on the Direct Linear
Transformation (DLT) method 3D [14-15]. Eq. (1)
describes a CCD camera model.
0 v
0 u
v y
k v
u x
k u


where (u
, v
) are the principal points coordinates, (u, v)
are the image coordinates of the relative points and (k
) are the pixel reverse effective size in the (u, v)
An accurate camera model has to consider the radial
distortion of the lens system. A standard model is a
transformation from ideal coordinates, not distorted (u,
v), to real coordinates, distorted (u
, v
( ) ( )
( ) ( )

+ + =
+ + =
D 1 0 D
D 1 0 D
v r k 1 v v v
u r k 1 u u u
( ) ( )
0 2
v v u u


v v
u u

Eq. (3) shows the focal length in terms of horizontal
and vertical pixels.

Fig. 8 Camera model.

To calibrate the distortion, we consider the distorted
pixel coordinates (u
, v
) in the real image and the
coordinates of the same point (u, v) on the calibration
chessboard. Using Eq. (3), Eq. (2) becomes
( )
( ) ( )
( )
( ) ( )

v v k
v v u u
v v
u u k
v v u u
u u
D 1
D 1

where the unknown parameters are u
, v
, k
Once known k
, the radial distortion in the acquired
image can be compensated. To calculate the other
intrinsic parameters we use the DLT method. Using
Eqs. (1) and (4), the equation which describes a
standard camera model is obtained.
) z z ( c ) y y ( b ) x x ( a
) z z ( c ) y y ( b ) x x ( a
f v v
) z z ( c ) y y ( b ) x x ( a
) z z ( c ) y y ( b ) x x ( a
f u u
0 c 3 0 c 3 0 c 3
0 c 2 0 c 2 0 c 2
0 c 3 0 c 3 0 c 3
0 c 1 0 c 1 0 c 1
+ +
+ +
+ +
+ +
Here f is an intrinsic parameter; {a
, a
, a
} are the
elements of the Rotation Matrices; (x
, y
, z
) are the
projection centre points; (x, y, z) are the spatial
3.2 Projector Calibration
Also the projector calibration by the DLT method is
defined. The projector is studied as a reverse camera;
note that in Eq. (5) the Z coordinate is set to zero.
) y y ( b ) x x ( a
) y y ( b ) x x ( a
f v v
) y y ( b ) x x ( a
) y y ( b ) x x ( a
f u u
0 p 3 0 p 3
0 p 2 0 p 2
0 p 3 0 p 3
0 p 1 0 p 1
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning

In Eq. (6) (u
, v
, f) are the projector intrinsic
coordinates; (x
, y
) are the projector centre coordinates;
(x, y) are the spatial coordinates; (u, v) are the image
coordinates of the relative points and {a
,..} are
the Rotation Matrices elements. To obtain the intrinsic
and extrinsic parameters shown in Eq. (6) a new
method was used. This method allows to considerer the
projector as an inverse camera, through the use of a
dedicated algorithm that processes the in-plane
coordinates of specific points in a projected calibration
chessboard, acquired by the two micro-cameras. The
two cameras record a set of several images, each
representing a different position of the camera
calibration chessboard. Once acquired the image for
the two cameras, the planar calibration chessboard is
covered with a white paper, and a green and black
chessboard is projected on the white paper. The two
cameras acquire the scene and the algorithm records
this images. During the acquisition phase it is
important not to change the chessboards angulations.
3.3 Scanner Calibration
At this point all the calibration parameters are
processed with an active triangulation system in order
to determine the poses of the two micro-cameras 3D
with respect of the projector pose, in terms of
roto-translational matrix transformation. These
transformation operators allow to describe all points of
interest with respect to a universal coordinate system.
Particularly, the algorithm loads the camera and
projector calibration data. The camera reference
system does not coincide with the projector reference
system, so there is the need to introduce a rigid
transformation which links the two reference systems.
A coordinates change, composed by a rotation (R)
followed by a translation (t), is introduced. If m

indicates the plane homogeneous coordinates in the
camera reference system and m
the same plane
homogeneous coordinates in the world reference, we
can write
1 c 1c
m G m =

1 0
t R
c c



Having assigned the position with respect to the
camera reference system, the same plane position with
respect to the projector reference system is identified.
Also in this case a coordinate change is needed to link
the world reference system with the projector reference
system. The relationship is the same used in Eq. (7),
where m
are the plane homogeneous coordinates in
the projector reference system:
1 p p 1
m G m = (8)
Knowing Eqs. (7) and (8), the relative position
between camera and projector can be calculated using
the following relationship:
p c pc

3.4 Acquisition Phase
The shape detection is achieved by the structured
light method. To implement this particular technique, it
is necessary to project a Gray-Code pattern together
with the Phase-Shift to avoid the problem of the
matching between the points of the image plane of the
micro-cameras and the points of the image plane of the
projector [16-17]. This codifying process allows to
generate 2
lines with bright and dark pixels, where n is
the number of bits and depends on the projector
resolution. In our particular case we projected 256 lines.
We also used a particular pattern: the Gray-Code
pattern is followed by seven projections shifted by 1/8
phase. The shape detection is achieved by a
multi-vision scanning process, whereas the two cameras
simultaneously acquire a tooth side each (Fig. 9).
3.5 Processing Phase
To obtain a CAD model it is necessary to correlate
the data acquired from the cameras with the projector
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning


Fig. 9 Gray-code with phase shift.

data. The transformation (R, t) that changes the
coordinates from the camera reference frame to the
reference frame of the projector are derived from the
calibration process and may be given by the following
t m R m
c p
+ = (9)
where m
are the point coordinates acquired from
camera and m
are the point coordinates illuminated by
projector. A generic point m is described on the camera
plane image by the point p
in Eq. (10):
c c
c c
z y
z x
p =

= (10)
The projected point vertical coordinate is unknown.
Let p
be the coordinate of the point which illuminates
m. The point m is projected on the point p
on projector
image plane.
p =
Using Eqs. (9)-(11) the vector equation is obtained:
t Rp z p z
c c p p
= (12)
Decomposing Eq. (12) on a three linear equations
system, the point m depth (z
) is known [14].
3 p
p 3 1
)p r r (u
u t t


4. Scanner Calibration Results
4.1 Camera Calibration
The camera calibration is calibrated using the
Camera Calibration Toolbox for Matlab
. We use a

surface with a printed checkerboard pattern and
we take about 20 images of it in different position
(Fig. 10).
The results of this calibration is shown in Table 1
where the last element is the calibration error (
4.2 Projector Calibration
To calibrate the projector with the novel algorithm,
only three images are needed, one of the chessboard, to
determine its position with respect to the camera and
two images of the projected pattern, a positive and a
negative (Figs. 11a-11b). The actual images that are
used for projector calibration are the result of the
subtraction of the two aforementioned images (Fig.
11c). The calibration of the projector is almost

Fig. 10 Specimen calibration in different position.

Table 1 Results from traditional acquisition.
Parameters Left cam Right cam
u 498.24.00 295.76
v 467.09.00 552.39.00
u -0.069 0.041
v -0.066 -0.087
f 6,8861111 -0.3402
304.83 409
248 273
23.633 20.163
14.986 11.293
-0.9916 2,41875
x -224.683 -1.213.483
y 16.953 -591.193
z 4.262.155 3.920.633

921 897

893 858
-2793.93 -2718.18
-3307.66 -3177.77

1,52052 0,3132
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning


(a) (b) (c)
Fig. 11 Projected images: (a) positive; (b) negative; (c)

independent of the camera calibration [18], but for the
points projected position, which depends from the
planes orientation, as determined by the camera.
However this dependence is rather weak.
Besides that, the calibration projector process is
similar to that used for cameras. In fact, as in the
camera calibration, 20 images are obtained, one for
each chessboard position (Fig. 12). The projector
parameters are obtained by the correlation of a target
set of coordinates placed on a projected calibration
specimen with its the corresponding coordinates on the
plane image. The results of this process are shown in
Table 2.
4.3 Acquisition Phase
Once the scanner calibration parameters have been
obtained is possible to pass to the acquisition phase for
reconstruction of a model. Using the Gray Code
described in the previously paragraph, is possible to
obtain the follow images (Fig. 13). The process starts
with the 1 bit image, terminating with the 7 bit one. Of
each image both a positive and a negative image are
recorded. At the end of this process the various images
are obtained in binary code (Fig. 14).
4.4 Surface Generation
Once the individual point cloud has been obtained in
the camera system of reference, it has to be converted
in the mechanical slider system of reference, in order to
enable the generation of the entire point cloud.
In order to do so a further calibration is needed,
using a particular new chessboard (Fig. 15), in which it
is possible to correlate motion of the sliders with the
systems of reference established on the chessboard.

Fig. 12 Specimen projector calibration in different

Table 2 Projector and camera calibration parameters
with the novel algorithm.
u 7.164.829 498.24.00 171.61 295.76
v 4.518.913 467.09.00 461.39.00 552.39.00
u -0.06957 -0.069 0.03837 0.041
v -0.01143 -0.066 -0.0467 -0.087
f -0.451 6,8861111 -0.34 -0.3402
511.05.00 304.83 285 409
383.05.00 248 182 273
-17.055 23.633 20.163 20.163
-21.848 14.986 11.293 11.293
3,1326389 -0.9916 2,41875 2,41875
x -510.221 -224.683 -1.213.483 -1.213.483
y 43.601 16.953 -591.193 -591.193
z 4.981.056 4.262.155 3.920.633 3.920.633

975.07.00 921 285.000 897

1615.03.00 893 182.000 858
-2956.66 -2793.93 -863.63 -2718.18
-5982.59 -3307.66 -674.74 -3177.77

5,4548611 3,73888889

Fig. 13 Projected gray-code.

Next Fig. 16 shows as example the image recorded
by the same camera after a displacement of the slides.
Every scan is registered and properly aligned with
respect to the universal reference coordinate system in
order to obtain the whole three-dimensional dental arch
model (Fig. 17).
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning


Fig. 14 Images after the subtraction technique.

Fig. 15 Chessboard with identification marks.

Fig. 16 Two chessboard pictures showing the same point
observed from two different positions.

Fig. 17 CAD model of dental arch.

Once the three-dimensional model of the oral cavity
is created, the doctor may decide the best position for
the implants in order to obtain the desired results. A
numerical control milling machine may produce a
prosthesis, which will be then ready to be installed into
the patients oral cavity. The surgeon may then proceed
with surgery, implanting the new artificial roots. Once
this is done, special identifying abutments may be
finally placed on the implants.
5. Implant Positioning
Once obtained the dental CAD model, the dentist
can decide where to place the implants in the patients
mouth. It uses a new system based on a serial/parallel
robot with 2+1 DOF. This system is basically a four bar
link, whose frame may rotate about its longitudinal axis,
actuated by two step motors that, trough two worm
gears, move two rods acting in directions mutually
parallel on the first bar of a four bar link, while on the
third bar a slide allows the doctor to manually control
the motion of the implant micro-motor (Fig. 18). Two
digital encoders measure the angles, in order to
simplify the control. Thus this micro-robot is
essentially a serial robot, whose motion is controlled in
a parallel robot fashion, becoming extremely strong,
but having a minimal impact on the patients mouth
since all the gearing is external.
The procedure to utilize the system is the following.
First step is the acquisition of a CAT record of the
patients mouth. Then the doctor has to decide where to
place the implants navigating within the 3D
representation of the patient mouth, taking into account
all problems connected with implantation in that
particular mouth. Next the intraoral mask for vestibular
support is inserted in the mouth and fixed against a
second mask placed under the chin, if the jaw is to
undergo surgery, otherwise, for the upper denture,
simply putting straps on the head to secure the mask
against the upper vestibular surface.
Once this is done, a complete scanning of the mouth
is to be performed, in order to establish the
correspondence between the CAT representation and
the actual patient mouth, thus locating with precision
the positions in which the implants have to be fitted.
Dental Arch3D Direct Detection System from the Patients Mouth and Robot for Implant Positioning




Fig. 18 Robotic system for guiding implant positioning: (a)
up and down; (b) left and right; (c) forward and backward.

Finally the 3D scanner has to be detached from its
base and substituted with the 2 + 1 DOF parallel robot,
and the system will guide the doctor assuming the
correct x, y position and angles that have been
previously established, and the doctor may proceed
with the implant fixation.
Once the implants are positioned, and relative
abutments installed, it is possible to repeat the scanning
process to determine both which shape the abutments
should assume, and consequently the final prosthesis
6. Conclusions
The paper presents the first results of a new scanning
device for intra-oral determination of the mouth model
and the associated guiding robot for implant
positioning, both based on a platform which is fixed to
the patients mouth through a self balanced 6 DOF arm
bearing a vestibular supporting mask. More work is
needed to complete the system, but it will be the first
system that allows determining via software the best
position for an implant and immediately positioning it
into the patient mouth.
The present work was partially supported by
Tecnologica Srl of Crotone PIA grant C01/0612/P
The authors wish to acknowlwdge the precious help
of Basilio Sinopoli, Sebastiano Meduri, Diego Pulice
and of the Lab personnel of Dipartimento di Meccanica
of Calabria University for their contribution to this
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