Augmented Reality (AR) is an increasingly prominent technology with diverse applications across various surgical disciplines. This study aims to develop and assess the feasibility of a novel AR application intended to aid surgeons in the clinical assessment of temporomandibular joint (TMJ) alterations necessitating surgical intervention. The application employs a multi-modality tracking approach, combining both marker-less and marker-based tracking techniques to concurrently track the fixed portion of the joint and the movable mandible involved in TMJ. For the marker-based tracking both a planar marker with a binary QR-code pattern and a cuboid marker that contains a unique QR-code pattern on each face were tested and compared. The AR application was implemented for the HoloLens 2 head-mounted display and validated on a healthy volunteer performing the TMJ task, i.e. the opening and closing of the mouth. During the task, video recordings from the HoloLens cameras captured the horizontal and vertical excursions of the jaw movements (TMJ movements) using virtual markers anchored to the AR-displayed virtual anatomies. For validation, the video-recorded TMJ movements during AR viewing were compared with standard kinesiographic acquisitions. The findings demonstrated the consistency between the AR-derived trajectories and the kinesiography curves, especially when using the cubic Multi Target tracker to follow the moving mandible. Finally, the AR application was experienced on a patient and it was extremely useful for the surgeon to diagnose alterations in the normal kinematics of the TMJ. Future efforts should be addressed to minimize the bulkiness of the tracker and provide additional visual cues for surgeons.

增强现实 (AR) 是一项日益突出的技术，在各个外科学科中都有广泛的应用。本研究旨在开发和评估一种新型 AR 应用的可行性，旨在帮助外科医生对需要手术干预的颞下颌关节 (TMJ) 改变进行临床评估。该应用程序采用多模态跟踪方法，结合无标记和基于标记的跟踪技术，同时跟踪 TMJ 涉及的关节固定部分和可移动下颌。对于基于标记的跟踪，测试并比较了具有二进制 QR 码图案的平面标记和每个面上包含唯一 QR 码图案的长方体标记。 AR 应用程序是在 HoloLens 2 头戴式显示器上实现的，并在执行 TMJ 任务（即张开和闭合嘴）的健康志愿者身上进行了验证。在任务过程中，HoloLens 摄像机的视频记录使用锚定到 AR 显示的虚拟解剖结构上的虚拟标记来捕获下颌运动（TMJ 运动）的水平和垂直偏移。为了进行验证，我们将 AR 查看期间视频记录的 TMJ 运动与标准运动记录采集进行了比较。研究结果证明了 AR 导出的轨迹与运动记录曲线之间的一致性，特别是在使用立方体多目标跟踪器跟踪移动的下颌时。最后，AR 应用在患者身上进行了体验，对于外科医生诊断 TMJ 正常运动学的变化非常有用。未来应致力于尽量减少跟踪器的体积，并为外科医生提供额外的视觉提示。