This is probably my favorite upgrade to Blue Sky Plan in the last 5 years! If you’ve ever done bone segmentation the old school, manual way in BSB, then you know how tedious a process it is. It was not uncommon for a difficult maxilla to take well over an hour and that does not include individually segmenting the roots of the teeth. So why is bone segmentation important?…. Because if you want to build a surgical guide directly on bone you must have an stl of the bone to build the guide on.
Here’s a case I’m working on where I’ve just opened the CT and pulled in the intraoral scans. To do the segmentation, you need to be in the Model Builder Module and then you’ll open the Segmentation panel. Just choose Automatic Jaw Segmentation and tell it if you want to do 1 or both jaws and whether you want it to separate the teeth from the bone.
There’s several AI segmentation options out there currently and I’ve used them all. Here’s the things I love about BSB’s and why I prefer it
– It’s fast: in my experience, times will range from 2 minutes to 8 minutes depending on whether you’re doing 1 or both arches, whether you want to segment teeth too, and just the overall processing power of your computer. Even with some of the other great AI services, I found that I usually spent at least 10 minutes uploading and downloading the files and another 5 to pull them back into BSB. With this, you run the segmentation and you’re DONE……..everything is there and ready to begin work
– No file transfers- Since I’m already making my guides in BSB, it’s so nice to be able to do this within a single program which I’m already working with. I don’t have to save files, upload them to a service, wait for processing, download the files, and re-import them. With this, you eliminate all those extra steps……just run the segmentation and within a few minutes, everything is in place and you’re ready to start planning/making guides
– Files are already stitched in place with the ct data- sometimes with other programs I’ve used, the files would be out of orientation with the ct and I’d have to go back and re-stitch them
– You get a chance to preview and edit the segmentation- This is probably my favorite. As good as these AI segmentations are, there’s often a small area that they may miss. When I’d get the files back and evaluate them, if there was a missed area, I’d have to go back and manually segment those areas. With BSB, it actually stops once it performs the segmentation and gives you the opportunity to evaluate it before finalizing. This way if there’s a missed area, I can use the tools to edit (in red box) the data very quickly and get it perfect before finalizing. I rarely have to do any editing unless it’s a case with lots of scatter and even then it’s usually minimal. This pic shows a slice of the preview before any editing……..it was dead on with the bone in red and the roots in purple. Since there was nothing to edit, I just pushed finalize.
– Accurate tooth segmentation- BSB now segments every individual tooth root and builds the true socket walls into the bone segmentations. It has also drastically improved it’s scatter reduction. I’ve found it to be so accurate that I’ve made surgical guides directly on the tooth segmentation from the CT only (no intraoral scans) and the guides fit great. I’m not necessarily advocating that but I have done it and it worked great. The thing you won’t have if you try this is the soft tissue so you have to leave the guide edges above any soft tissue like the papilla. I’m not a big ortho guy but the tooth segmentation has a lot of great applications for ortho too……to my knowledge, BSB is the only ortho aligner software that segments the teeth/roots and reflects the root movements in each step. This can remove the risk of pushing roots out of the bone in your ortho cases.
Look at the accuracy of the segmented root outlines compared to the IOS outline
Here’s a video I made on the process but it’s pretty self explanatory
This build is available to anyone who wants it right now but it’s not a public release yet. That means you can’t just download it off the BSB website. You’ll have to go to the Blue Sky Bio Users Group on Facebook and just search for Michael Saltzmann’s post that shares the download link. This should be a fully public release within the next few weeks. If you ever make bone supported guides, I’d highly recommend you download this and try it!
I’ll share some more cases soon of how I’m using this.
