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Ligaments anatomy should be considered, and if necessary decompensation can be achieved with minimal surgical interventions. The proper fit of the template is crucial and should be maintained throughout the whole treatment. Regardless of the mucosal resilience, a correct and stable attachment is achieved through the bone fixation. The access to the jaw can now only be achieved through the sleeves embedded in the surgical template. Using specific burs through the sleeves the mucosa is removed. Every bur used, carries a sleeve compatible to the sleeves in the template, which ensures that the final position is achieved but no further progress in the alveolar ridge can take place. Further procedure is very similar to the traditional implant placement. The pilot hole is drilled and then expanded. With the aid of the splint, the implants are finally placed. After that, the splint can be removed.
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discomfort. Complications such as injuring of neighbouring structures are also avoided. Using 3D imaging during the planning phase, the communication between the surgeon, dentist and dental technician is highly supported and any problems can easily detected and eliminated. Each specialist accompanies the whole treatment and interaction can be made. As the end result is already planned and all surgical intervention is carried according to the initial plan, the possibility of any deviation is kept to a minimum. Given the effectiveness of the initial planning the whole treatment duration is shorter than any other treatment procedures.
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placed in the terminal position. After the self-curing process, the gold caps are definitely cemented in the prosthesis cavities and the prosthesis can now be detached. Excess cement may be removed and some corrections like polishing or under filling around the secondary crowns may be necessary. The new prosthesis is fitted using a construction of telescope double cone crowns. At the end position, the prosthesis buttons down on the abutments to ensure an adequate hold.
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the position of the implants determined. The surgeon, using special developed software, plans the implants based on prosthetic concepts considering the anatomic morphology. After the planning of the surgical part is completed, a CAD/CAM surgical guide for dental placement is constructed. The mucosal-supported surgical splint ensures the exact placement of the implants in the patient. Parallel to this step, the new implant supported prosthesis is constructed.
197:, requires the surgeon to manipulate the robotic arms during the procedure rather than allowing the robotic arms to work from a predetermined program. With shared-control systems, the surgeon carries out the procedure with the use of a robot that offers steady-hand manipulations of the instrument. In most robots, the working mode can be chosen for each separate intervention, depending on the surgical complexity and the particularities of the case.
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437:, increased processor speeds, and more complex and capable software will increase the cost of these systems. Another disadvantage is the size of the systems. These systems have relatively large footprints. This is an important disadvantage in today's already-crowded operating rooms. It may be difficult for both the surgical team and the robot to fit into the operating room.
420:. This way, the surgeon can easily assess most of the surgical difficulties and risks and have a clear idea about how to optimize the surgical approach and decrease surgical morbidity. During the operation, the computer guidance improves the geometrical accuracy of the surgical gestures and also reduce the redundancy of the surgeonâs acts. This significantly improves
147:) provide the detail of soft vs hard tissue structures, and thus allow a computer to differentiate, and visually separate for a human, the different tissues and structures. The image data taken from a patient will often include intentional landmark features, in order to be able to later realign the virtual dataset against the actual patient during surgery. See
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Robotic surgery can be divided into three types, depending on the degree of surgeon interaction during the procedure: supervisory-controlled, telesurgical, and shared-control. In a supervisory-controlled system, the procedure is executed solely by the robot, which will perform the pre-programmed actions. A telesurgical system, also known as
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of the patient, as the surgeon moves the instrument. The surgeon thus uses the system to 'navigate' the location of an instrument. The feedback the system provides of the instrument location is particularly useful in situations where the surgeon cannot actually see the tip of the instrument, such as in minimally invasive surgeries.
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diagnostic. Furthermore, the surgical intervention will be planned and simulated virtually, before actual surgery takes place (computer-aided surgical simulation ). Using dedicated software, the surgical robot will be programmed to carry out the planned actions during the actual surgical intervention.
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that reproduces the exact geometrical situation of the normal and pathological tissues and structures of that region. Of the available scanning methods, the CT is preferred, because MRI data sets are known to have volumetric deformations that may lead to inaccuracies. An example data set can include
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The dental technician, using the data resulting from the previous scans, manufactures a model representing the situation after the implant placement. The prosthetic compounds, abutments, are already prefabricated. The length and the inclination can be chosen. The abutments are connected to the model
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Using cone beam computed tomography, the patient and the existing prosthesis are being scanned. Furthermore, the prosthesis alone is also scanned. Glass pearls of defined diameter are placed in the prosthesis and used as reference points for the upcoming planning. The resulting data is processed and
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It is also used in implantology where the available bone can be seen and the position, angulation and depth of the implants can be simulated before the surgery. During the operation surgeon is guided visually and by sound alerts. IGI (Image Guided
Implantology) is one of the navigation systems which
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In computer-assisted surgery, the actual intervention is defined as surgical navigation. Using the surgical navigation system the surgeon uses special instruments, which are tracked by the navigation system. The position of a tracked instrument in relation to the patient's anatomy is shown on images
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is such a system that has a lightweight linear accelerator mounted on the robotic arm. It is guided towards tumor processes, using the skeletal structures as a reference system (Stereotactic
Radiosurgery System). During the procedure, real time X-ray is used to accurately position the device before
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With the advent of computer-assisted surgery, great progresses have been made in general surgery towards minimal invasive approaches. Laparoscopy in abdominal and gynecologic surgery is one of the beneficiaries, allowing surgical robots to perform routine operations, like cholecystectomies, or even
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Image-guided surgery and CAS in ENT commonly consists of navigating preoperative image data such as CT or cone beam CT to assist with locating or avoiding anatomically important structures such as the optic nerve or the opening to the frontal sinus. For use in middle-ear surgery there has been some
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The new prosthesis corresponds to a conventional total prosthesis but the basis contains cavities so that the secondary crowns can be incorporated. The prosthesis is controlled at the terminal position and corrected if needed. The cavities are filled with a self-curing cement and the prosthesis is
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The fit of the surgical splint is clinically proved. After that, the splint is attached using a three-point support pin system. Prior to the attachment, irrigation with a chemical disinfectant is advised. The pins are driven through defined sheaths from the vestibular to the oral side of the jaw.
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New therapeutic concepts as guided surgery are being developed and applied in the placement of dental implants. Guided surgery in the field of
Implant Dentistry is currently described as "Computer Assisted Implant Dentistry" (CAIS) which presently encompasses three distinct technologies: static,
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With the aid of a registration template, the abutments can be attached and connected to the implants at the defined position. No less than a pair of abutments should be connected simultaneously to avoid any discrepancy. An important advantage of this technique is the parallel positioning of the
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Robotic surgery is a term used for correlated actions of a surgeon and a surgical robot (that has been programmed to carry out certain actions during the preoperative planning procedure). A surgical robot is a mechanical device (generally looking like a robotic arm) that is computer-controlled.
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At the same sitting, the patient receives the implants and the prosthesis. An interim prosthesis is not necessary. The extent of the surgery is kept to minimum. Due to the application of the splint, a reflection of soft tissues in not needed. The patient experiences less bleeding, swelling and
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The prosthetic rehabilitation is also planned and performed parallel to the surgical procedures. The planning steps are at the foreground and carried out in a cooperation of the surgeon, the dentist and the dental technician. Edentulous patients, either one or both jaws, benefit as the time of
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Using specialized software the gathered dataset can be rendered as a virtual 3D model of the patient, this model can be easily manipulated by a surgeon to provide views from any angle and at any depth within the volume. Thus the surgeon can better assess the case and establish a more accurate
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Image analysis involves the manipulation of the patients 3D model to extract relevant information from the data. Using the differing contrast levels of the different tissues within the imagery, as examples, a model can be changed to show just hard structures such as bone, or view the flow of
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hysterectomies. In cardiac surgery, shared control systems can perform mitral valve replacement or ventricular pacing by small thoracotomies. In urology, surgical robots contributed in laparoscopic approaches for pyeloplasty or nephrectomy or prostatic interventions.
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Applications include atrial fibrillation and cardiac resynchronization therapy. Pre-operative MRI or CT is used to plan the procedure. Pre-operative images, models or planning information can be registered to intra-operative fluoroscopic image to guide procedures.
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dynami and robotic. Static utilises prefabricated guides to direct osteotomy and implant placement, dynamic is based or real time tracking of the drills position through optical technology while robotic includes implant placement by autonomous robotic arm.
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by 10-fold), increased accuracy and precision of the intervention. It also opened a new gate to minimally invasive brain surgery, furthermore reducing the risk of post-surgical morbidity by avoiding accidental damage to adjacent centers.
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plus many more. For the generation of this model, the anatomical region to be operated has to be scanned and uploaded into the computer system. It is possible to employ a number of scanning methods, with the datasets combined through
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There are several disadvantages of computer-assisted surgery. Many systems have costs in the millions of dollars, making them a large investment for even big hospitals. Some people believe that improvements in technology, such as
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CAS starts with the premise of a much better visualization of the operative field, thus allowing a more accurate preoperative diagnostic and a well-defined surgical planning, by using surgical planning in a preoperative
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Mischkowski RA, Zinser MJ, Ritter L, Neugebauer J, Keeve E, Zoeller JE (2007b) Intraoperative navigation in the maxillofacial area based on 3D imaging obtained by a cone-beam device. Int J Oral
Maxillofac Surg
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In a further step, abutments are covered by gold cone caps, which represent the secondary crowns. Where necessary, the transition of the gold cone caps to the mucosa can be isolated with rubber dam rings.
668:"Comparison of the accuracy of implant position for twoâimplants supported fixed dental prosthesis using static and dynamic computerâassisted implant surgery: A randomized controlled clinical trial"
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Computer-assisted surgery is the beginning of a revolution in surgery. It already makes a great difference in high-precision surgical domains, but it is also used in standard surgical procedures.
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Regarding the edentulous patients, conventional denture support is often compromised due to moderate bone atrophy, even if the dentures are constructed based on correct anatomic morphology.
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Paprosky WG, Muir JM. Intellijoint HIPÂŽ: a 3D mini-optical navigation tool for improving intraoperative accuracy during total hip arthroplasty. Med
Devices (Auckl). 2016 Nov 18;9:401-408.
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screw insertion during spinal fusion. It is also useful in pre-planning and guiding the correct anatomical position of displaced bone fragments in fractures, allowing a good fixation by
819:"Differential independent impact of the intraoperative use of navigation and angled endoscopes on the surgical outcome of endonasal endoscopy for pituitary tumors: a prospective study"
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at a position in consideration of the prosthetic situation. The exact position of the abutments is registered. The dental technician can now manufacture the prosthesis.
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572:"Can computerâassisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review"
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have been used for the first time in neurosurgery, in the 1980s. This allowed a greater development in brain microsurgery (compensating surgeonâs
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Pimkhaokham, Atiphan; Jiaranuchart, Sirimanas; Kaboosaya, Boosana; Arunjaroensuk, Sirida; Subbalekha, Keskanya; Mattheos, Nikos (October 2022).
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508:"What should my hospital buy next?âGuidelines for the acquisition and application of imaging, navigation, and robotics for spine surgery"
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The most important component for CAS is the development of an accurate model of the patient. This can be conducted through a number of
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Yimarj, Paweena; Subbalekha, Keskanya; Dhanesuan, Kanit; Siriwatana, Kiti; Mattheos, Nikos; Pimkhaokham, Atiphan (December 2020).
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Manbachi A, Cobbold RS, Ginsberg HJ: "Guided pedicle screw insertion: techniques and training." Spine J. 2014 Jan;14(1):165-79.
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in the operating theatre, decreases the risk of surgical errors, reduces the operating time and improves the surgical outcome.
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Schweikard, A., Shiomi, H., & Adler, J. (2004). Respiration tracking in radiosurgery. Medical physics, 31(10), 2738-2741.
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629:"The accuracy of static vs. dynamic computerâassisted implant surgery in single tooth space: A randomized controlled trial"
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abutments. A radiological control is necessary to verify the correct placement and connection of implant and abutment.
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Kaewsiri, Dechawat; Panmekiate, Soontra; Subbalekha, Keskanya; Mattheos, Nikos; Pimkhaokham, Atiphan (June 2019).
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The application of robotic surgery is widespread in orthopedics, especially in routine interventions, like total
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delivering radiation beam. The robot can compensate for respiratory motion of the tumor in real-time.
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the collection of data compiled with 180 CT slices, that are 1 mm apart, each having 512 by 512
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Computer-assisted navigation increases precision of component placement in total knee arthroplasty.
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procedures using navigation and robotics systems. Current navigation systems available include
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53:) represents a surgical concept and set of methods, that use computer technology for
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application of robotic surgery due to the requirement for high-precision actions.
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Cardiovascular and
Interventional Radiological Society of Europe Newsletter, 2006
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with CAS. CAS has been a leading factor in the development of
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Radiosurgery is also incorporating advanced robotic systems.
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Muntener M, Ursu D, Patriciu A, Petrisor D, Stoianovici D:
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is a hardware accelerated multiphysics simulation software
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Image gathering ("segmentation") on the LUCAS workstation
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surgery, or in the reconstruction of the mid-face and
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Diagnostic, preoperative planning, surgical simulation
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techniques. The final objective is the creation of a
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Surgical minimally-invasive endonasal tumor resection
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have been developed for hip arthroplasty procedures.
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795:What Robotics in Urology? A Current Point of View.
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248:Zeta; current robotics systems available include
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264:Computer-assisted oral and maxillofacial surgery
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672:Clinical Implant Dentistry and Related Research
506:Malham, Gregory M; Wells-Quinn, Thomas (2019).
816:Patil, NR; Dhandapani, S; et, al. (Oct 2020).
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738:Robotic Surgery - Squeezing into Tight Places
224:Computer-assisted neurosurgery also includes
77:, but these are terms that are more or less
344:Computer-assisted orthopedic surgery (CAOS)
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558:Computer-assisted bone segment navigation.
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560:J Cranio-Maxillofac Surg 26:347-359, 1998
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870:"Robotic Surgery: A Current Perspective"
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494:Robotics for interventional procedures.
389:Computer-assisted cardiac interventions
364:bones. Early CAOS systems include the
102:Creating a virtual image of the patient
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160:arteries and veins through the brain.
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753:Clin Orthop Relat Res 433:152-9, 2005
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271:is the modern surgical approach in
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797:European Urology. 43: 103-105 2003
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269:Bone segment navigation
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1764:Transmission
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1723:Oracle Argus
1713:Folding@home
1676:Presentation
1602:Radix Health
1548:OpenHospital
1259:EpicCare EMR
1147:CommonGround
936:
921:
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880:(1): 14â21.
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1574:Open Dental
1537:ClearHealth
1451:Epic Beaker
1385:Terminology
1289:INPS Vision
1162:Odontologic
1079:Ginkgo CADx
1034:Diagnostics
238:7D Surgical
129:data fusion
1589:Scheduling
1522:management
1433:management
1431:Laboratory
1222:Centricity
1189:Electronic
1137:Heuristics
1084:InVesalius
1041:Bioimaging
1025:Micromedex
922:asl.org.il
712:2023-10-01
483:36:687-694
470:References
411:Advantages
404:CyberKnife
370:OrthoPilot
362:malrotated
124:ultrasound
79:synonymous
1742:Assistive
1622:Dentaltap
1562:Specialty
1397:SNOMED CT
1392:Read code
1343:PrognoCIS
1307:WebEHR2.0
1199:Platforms
1010:Epocrates
1003:Databases
986:Barcoding
852:224824578
692:1523-0899
653:0905-7161
596:0906-6713
230:Medtronic
1823:Category
1734:Surgical
1708:DreamLab
1691:PsyScope
1681:PsychoPy
1661:Research
1579:SoftDent
1520:Practice
1466:STARLIMS
1461:MEDITECH
1371:VITAband
1361:SystmOne
1254:EMIS Web
1170:Cybermed
1152:EuResist
1143:Bestbets
1089:ITK-SNAP
1064:3DSlicer
1020:Medscape
1015:Lexicomp
904:14685095
844:33089448
614:35924457
544:31032450
441:See also
422:ergonomy
258:Brainlab
234:BrainLab
25:ICD-9-CM
1786:Related
1697:Cancer
1648:Vezeeta
1638:AbbaDox
1617:Vezeeta
1597:AbbaDox
1569:Dentrix
1510:MyChart
1494:AbbaDox
1471:webLIMS
1333:OpenMRS
1326:OpenEMR
1269:GaiaEHR
1205:Apache
1120:Orthanc
1113:Servers
1069:Drishti
1057:General
895:1356187
605:9805105
535:6465454
354:pedicle
242:Stryker
136:dataset
1750:HipNav
1701:Caisis
1612:Zocdoc
1504:Cerner
1417:RxNorm
1402:MEDCIN
1274:GNUmed
1264:EviMed
1239:COSTAR
1233:Cerner
1207:cTAKES
1104:Voreen
1094:OsiriX
1074:GIMIAS
902:
892:
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690:
651:
612:
602:
594:
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366:HipNav
260:Cirq.
254:Globus
244:, and
226:spinal
145:pixels
141:pixels
120:x-rays
1643:Kareo
1607:Kareo
1542:Kareo
1407:LOINC
1376:ZEPRS
1366:VistA
1294:Kareo
1284:HOSxP
1279:GPASS
1249:EMIAS
1244:Datix
1212:AHLTA
1049:DICOM
848:S2CID
281:orbit
250:Mazor
35:[
1671:PEBL
1553:RXNT
1446:ELab
1412:UCUM
1348:RXNT
1305:MTBC
900:PMID
840:PMID
688:ISSN
649:ISSN
610:PMID
592:ISSN
540:PMID
73:and
29:00.3
1358:TPP
1296:EHR
1235:EHR
1224:EMR
890:PMC
882:doi
878:239
832:doi
680:doi
641:doi
600:PMC
584:doi
530:PMC
520:doi
352:or
116:MRI
51:CAS
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