annotations/annotations_sample_L0_L5.json

{
 "schema": "case_002_mandible/public_sample_annotations/v1",
 "case": "case_002_mandible",
 "procedure": "All-on-4 / All-on-X full-arch mandibular implant placement, 5 implants",
 "timeline": {
  "clock": "seconds in demo/case_002_mandible_demo_7min.mp4 source master, i.e. the 3293.023 s edited case video",
  "note": "All structured time fields in this file are on the edited case video's clock, the same clock the burned-in timer of that video shows. Timecodes that appear inside free-text prose were written on the pre-edit clock and were not rewritten."
 },
 "layers": {
  "L0": "verbatim timestamped surgeon statements",
  "L1": "surgical phase, normalised label plus free-text detail",
  "L2": "instruments present, with confidence and provenance; list only, NO coordinates",
  "L3": "(instrument, action, target) triplets",
  "L4": "reasoning: why the frame reads the way it does",
  "L5": "clinical context around the frame"
 },
 "selection": {
  "rule": "every annotated keyframe that falls inside one of the nine 45-second LeRobot episode windows, plus the 54 keyframes of the annotated showcase",
  "n_frames": 184
 },
 "counts_for_this_sample": {
  "frames": 184,
  "L0_statements": 234,
  "L2_instrument_observations": 848,
  "L3_triplets": 283
 },
 "frames": [
  {
   "keyframe_id": "lumix_overhead_0000",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 12.0,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 12.0,
     "statement": "Now we're going to start making incisions in the mouth here.",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "field set-up before the first incision, edentulous anterior mandible, no cutting instrument in the field yet",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "keratinized gingiva",
    "oral mucosa",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "holds the lips and cheeks away and keeps the mouth open for the field setup",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Opening frame of the phase: the surgeon announces out loud that the incisions are starting, but there is not yet a single cutting instrument in the field. The field is prepared - the lips and cheeks are held away by the OptraGate, the view of the edentulous mandibular alveolar ridge is open. The frame records the baseline state of the tissues before the first incision, which matters as the reference point for all the annotation that follows.",
   "L5_clinical_context": "The mandible is edentulous in the anterior region, the mucosa is intact, there is no bleeding. Above, the retained maxillary teeth with metal crowns and a gold crown are visible - a landmark for the midline and for the side. The tongue is raised, the frenulum and the floor of the mouth are visible. The case plan is 4-5 implants between the mental foramina, so the incision will run along the crest in the interforaminal zone.",
   "uncertainty": "There are no instruments in the field and the incision has not been started - from the frame it is impossible to say with which blade and from which side the surgeon will begin. At the upper left, at the edge of the frame, there is an indistinct dark object (possibly a line tubing or an instrument) that cannot be identified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0000",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 12.0,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 12.0,
     "category": "milestone",
     "statement": "Now we're going to start making incisions in the mouth here."
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "pre-incision overview of the mandibular arch, field prepared, before the first crestal incision",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "lower lip",
    "upper lip",
    "tongue",
    "mandibular teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "oral mucosa",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts lips and cheeks to expose the operative field",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Opening frame of the phase: the field is prepared, the lips and cheeks are held apart by the OptraGate, the patient is under sedation with a nasal cannula. The surgeon announces the start of the incisions - the frame records the initial state of the tissues before the first movement of the scalpel, and it is the reference point for the before/after comparison of flap elevation.",
   "L5_clinical_context": "Mandible, lateral view. Remaining teeth with metal-ceramic/gold crowns and edentulous stretches of the ridge are visible; their position determines the line of the crestal incision. The incision is planned between the mental foramina, so a view of the whole anterior segment is mandatory. Sedation plus nasal oxygen means the airway is not protected by intubation: control of saliva and blood with suction is critical.",
   "uncertainty": "There is not a single surgical instrument in the oral cavity in this frame and the incision has not been started, so it is impossible to tell from the frame which side will be incised first. The type of the crowns (gold/alloy) cannot be established from the image.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0005",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 77.4,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 71.3,
     "category": "technique",
     "statement": "tissue. Evenly, so we don't have water with that gingiva, but we want some niche style."
    },
    {
     "time": 82.26,
     "category": "technique",
     "statement": "And we're going to make a little release right there. So the reason why we do those releases"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "immediately before the first release incision, retractor holding traction, field occluded by the surgeon's hand",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "lower lip",
    "upper lip",
    "dental crown (existing restoration)",
    "gingiva",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "keeps traction on the cheek and vestibular tissue",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The surgeon explains the principle: the tissue is distributed evenly, the gingiva is not allowed to dry out, and a release incision is about to be made. The retractor keeps up the traction, freeing the second hand for the scalpel.",
   "L5_clinical_context": "Release incisions are made at the ends of the main crestal incision so that the flap can be raised without tension. In an All-on-4 in the mandible, sufficient mobilization of the flap is needed for the exposure to reach the mental foramina on both sides.",
   "uncertainty": "The oral cavity is almost completely covered by the surgeon's hand and the assistant's forearm - neither the incision nor the crest is visible in the frame. The line at 59.3 s is distorted in the transcript ('that ginger', 'niche style'): 'ginger' is confirmed by the surgeon on 2026-08-05 (round 3, question term_ginger_v2) as 'gingiva' and corrected in the transcript and in the L0 quote; 'niche style' is still unrecovered, so the meaning of the sentence as a whole is rendered cautiously in L4. Unidentified objects in the frame: a dark object with graduations at the upper right edge of the frame - possibly a measuring ruler or a probe, type cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0006",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 79.8,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 71.3,
     "category": "technique",
     "statement": "tissue. Evenly, so we don't have water with that gingiva, but we want some niche style."
    },
    {
     "time": 82.26,
     "category": "technique",
     "statement": "And we're going to make a little release right there. So the reason why we do those releases"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "release incision cut with the scalpel at the end of the crestal incision, first side",
   "L2_instruments": [
    {
     "name": "scalpel",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mandibular teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "oral mucosa",
    "tongue",
    "blood"
   ],
   "L3_triplets": [
    [
     "scalpel",
     "makes a release incision at the end of the crestal incision",
     "gingiva"
    ],
    [
     "metal retractor blade",
     "holds the flap margin aside for access",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The moment the surgeon is talking about: a release incision is performed with the scalpel. The point is to take the tension off the flap so that it does not tear during elevation ('not to have tears' from the adjacent line).",
   "L5_clinical_context": "A release incision in the lateral part of the mandible runs vertically from the crest into the vestibule; its depth is limited by the periosteum. The mental nerve runs below and more buccally, so the incision is not deepened blindly. The assistant's fenestrated metal blade simultaneously protects the cheek from the blade.",
   "uncertainty": "The scalpel blade is blurred by motion in the frame; the exact site and length of the incision cannot be measured. Whether the retractor in the right part of the frame is a cheek retractor and not a tongue retractor cannot be determined from this angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0008",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 86.8,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 71.3,
     "statement": "tissue. Evenly, so we don't have water with that gingiva, but we want some niche style.",
     "category": "technique"
    },
    {
     "time": 82.26,
     "statement": "And we're going to make a little release right there. So the reason why we do those releases",
     "category": "technique"
    },
    {
     "time": 90.82,
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want",
     "category": "safety"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "scalpel cutting a short vertical releasing incision at the end of the crestal incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "scalpel",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "fenestrated tongue retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "keratinized gingiva",
    "oral mucosa",
    "tongue",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "scalpel",
     "cuts a short vertical releasing incision at the end of the crestal incision",
     "oral mucosa"
    ],
    [
     "metal retractor blade",
     "holds the tongue away so the incision line stays under direct vision",
     "tongue"
    ]
   ],
   "L4_reasoning": "A key frame: the scalpel making the releasing incision is clearly visible in the field, and at exactly this moment the surgeon explains why it is done - so that the flap does not tear during elevation and retraction. A tear of the flap means loss of keratinized tissue and problems with suturing, which is why releasing incisions are made in advance and not when the flap is already under tension.",
   "L5_clinical_context": "Releasing incisions in the anterior region of the mandible are made vertically, within the mobile mucosa of the vestibule, and must not extend into the projection of the mental foramen. The remark about \"evenly\" and the gingiva is about the even division of the keratinized tissue between the flaps.",
   "uncertainty": "The blade number and the type of scalpel handle cannot be determined from the frame. The remark at 59.3 s was poorly recognized: 'ginger' is confirmed by the surgeon on 2026-08-05 (round 3, question term_ginger_v2) as 'gingiva' and is corrected throughout; 'niche style' in the same line still cannot be deciphered, so the sentence is only partly reconstructed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0009",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 93.8,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 82.26,
     "statement": "And we're going to make a little release right there. So the reason why we do those releases",
     "category": "technique"
    },
    {
     "time": 90.82,
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want",
     "category": "safety"
    },
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "releasing incision on the first side completed, surgeon announcing the move to the opposite side, anterior mandible",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "fenestrated tongue retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "keratinized gingiva",
    "oral mucosa",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the tongue and the lip to check the completed releasing incision",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The incision on this side is done - the mucosal edges at the crest have separated, blood is visible along the line of the cut. The surgeon confirms the result in words (\"I have a good release\") and announces the move to the opposite side: the work proceeds symmetrically, on the left and on the right, in order to obtain one continuous flap across the midline.",
   "L5_clinical_context": "A continuous crestal incision with releasing incisions at both ends gives a flap that can be reflected over the whole interforaminal zone - that is exactly where the 4-5 implants are planned. The bleeding remains capillary, no large vessels have been touched.",
   "uncertainty": "The scalpel is not visible in the field in this frame - a moment between the two incisions. How far the incision has already been extended towards the opposite side cannot be determined from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0010",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 95.8,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 82.26,
     "statement": "And we're going to make a little release right there. So the reason why we do those releases",
     "category": "technique"
    },
    {
     "time": 90.82,
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want",
     "category": "safety"
    },
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "pause between the two sides, retractors holding the field, wide view of the face with the nasal cannula",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "nose",
    "tongue",
    "oral mucosa",
    "mandibular alveolar ridge",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "keeps the tongue retracted while the surgeon repositions for the opposite side",
     "tongue"
    ],
    [
     "nasal oxygen cannula",
     "delivers oxygen to the sedated patient during the procedure",
     "nose"
    ]
   ],
   "L4_reasoning": "The camera / field has shifted and the whole face gets into the frame - the nasal oxygen cannula is visible. The surgical action at this moment is a pause: the retractors hold the field, the surgeon is moving to the opposite side. The value of the frame is that it documents the sedation setup rather than the incision itself.",
   "L5_clinical_context": "The case is being done under sedation, breathing is preserved, oxygen is delivered through a nasal cannula - when working inside the oral cavity this is essential: the mouth is occupied by instruments and a retractor, while the nasal route stays free. Midline control by the nose and the retained upper teeth is also visible.",
   "uncertainty": "The surgical field in the lower part of the frame is darkened and cropped - the state of the incision line cannot be assessed from it.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0011",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 99.2,
   "phase_index": 1,
   "image_quality": "degraded",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 90.82,
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want",
     "category": "safety"
    },
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "transition between the two sides with the incision already made, retraction held (motion-blurred frame)",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "remains in the mouth retracting the tongue during camera/hand movement",
     "tongue"
    ]
   ],
   "L4_reasoning": "A technically defective frame: heavy blur from camera movement. From the context of the speech this is the same moment - the incision on one side is finished, the surgeon is moving to the other. In terms of content the frame adds nothing to the annotation, but it is marked as degraded and kept for the continuity of the time series.",
   "L5_clinical_context": "In the blurred image only the OptraGate ring, a dark retractor in the oral cavity and a red spot in the area of the crest can be guessed at - that is, an incision that has already been made, with bleeding.",
   "uncertainty": "The frame is blurred by movement, the details of the surgical field cannot be made out: neither the incision line, nor the instruments in the hands, nor the side on which the work is going on. All the listed objects were identified presumptively, by their shape and by the neighbouring frames.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0007",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 99.2,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 90.82,
     "category": "technique",
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want"
    },
    {
     "time": 96.74,
     "category": "technique",
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "inspection of the completed release incision on the first side, before moving to the contralateral side",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mandibular teeth",
    "dental crown (existing restoration)",
    "keratinized gingiva",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the cheek to expose the completed release incision",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The surgeon states that the release incision on this side has come out well and moves to the opposite side. The frame is a control inspection of the incision line: the edge is even, without tears, and the bleeding is pinpoint.",
   "L5_clinical_context": "The goal the surgeon formulates right here is four or five implants between the mental foramina. This determines the extent of the incision: it must expose the whole interforaminal segment but must not run further distally, where the risk of damaging the mental nerve is greatest.",
   "uncertainty": "The incision line itself is only partly visible because of the retractor blade; the integrity of the flap ('no tears') cannot be confirmed from the frame - only from the surgeon's words.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0012",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 101.6,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 90.82,
     "statement": "is we don't want to have tears, so that's the main thing, not to have tears. We want",
     "category": "safety"
    },
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "overview between the two releasing incisions while the surgeon repositions for the opposite side, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "nose",
    "tongue",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the tongue and holds the field open between the two releasing incisions",
     "tongue"
    ],
    [
     "nasal oxygen cannula",
     "supplies oxygen through the nose while the mouth is occupied by instruments",
     "nose"
    ]
   ],
   "L4_reasoning": "A wide-shot frame: the retractors hold the field, the surgeon changes position to work on the opposite side. The nasal cannula is visible again - confirmation of the sedation. There is no active cutting in the frame.",
   "L5_clinical_context": "The midline landmarks are the nose and the retained upper teeth: they make it possible to control the symmetry of the incision relative to the midline of the mandible, which matters for the subsequent symmetrical placement of the implants between the mental foramina.",
   "uncertainty": "The lower part of the field is darkened and partly covered by the fenestrated retractor - the incision line cannot be assessed. The second, darker instrument on the right has not been identified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0013",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 103.6,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    },
    {
     "time": 106.98,
     "statement": "four or five implants in between the mental foramina.",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "crestal incision continued on the opposite side while the interforaminal implant plan is stated, anterior mandible",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "fenestrated tongue retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "presses the tongue away from the crest to expose the anterior mandible",
     "tongue"
    ]
   ],
   "L4_reasoning": "It is in this window that the surgical plan is spoken out: 4-5 implants between the mental foramina. This explains both the extent of the incision and why the flap is reflected over the whole anterior arch - the interforaminal zone has to be exposed in full in order to place five implants (per the case facts, 5 x 4.3x13 mm).",
   "L5_clinical_context": "The interforaminal zone is the safe region of the mandible: between the mental foramina the inferior alveolar nerve has already exited, and the bone is available for osteotomy. The boundaries of this zone are exactly the mental foramina, which the surgeon will be looking for during the elevation.",
   "uncertainty": "The frame is dark, there is almost no light on the crest: the incision line can be made out only by the red spot at the bottom. What the hands are doing cannot be determined from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0014",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 105.6,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 96.74,
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do",
     "category": "milestone"
    },
    {
     "time": 106.98,
     "statement": "four or five implants in between the mental foramina.",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "completed midline vertical releasing incision with the crestal incision running laterally, anterior mandible",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "fenestrated tongue retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "keratinized gingiva",
    "oral mucosa",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "holds the tongue up and back, fully exposing the incised mandibular crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "A clean frame of the result: at the midline of the anterior region of the mandible a vertical releasing incision with fresh blood is distinctly visible, and the crestal incision runs off to the sides. At this time the surgeon states the plan for 4-5 implants between the mental foramina - the incision has already been drawn for that scope of work.",
   "L5_clinical_context": "A midline vertical incision in the anterior region is safe: the mental foramina and the nerves emerging from them lie laterally, in the projection of the premolars. The keratinized gingiva along the crest is cut through the middle, which will give tissue to both flaps.",
   "uncertainty": "The cutting instrument is absent from the frame - a moment between the incisions. How far the crestal incision has been extended laterally cannot be seen because of the retractor and the shadow.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0008",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 106.4,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": 0,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 96.74,
     "category": "technique",
     "statement": "I have a good release. Now I'm gonna do on this side. Again the goal is here to do"
    },
    {
     "time": 106.98,
     "category": "surgical_plan",
     "statement": "four or five implants in between the mental foramina."
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "switch to the contralateral side, retractor repositioned before the mirror-image release incision",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular teeth",
    "dental crown (existing restoration)",
    "mandibular alveolar ridge",
    "gingiva",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts lip and cheek on the contralateral side",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "Transition to the opposite side: the retractor has been repositioned and the surgeon brings in a second instrument in order to make the mirror-image release incision. At the same time he states the plan - four or five implants between the mental foramina.",
   "L5_clinical_context": "The interforaminal zone of the mandible is the standard implant region for an All-on-4: the bone here is dense and the inferior alveolar nerve has already exited through the mental foramen. The incision and the flap must expose both foramina so that they serve as the distal limits of the osteotomies.",
   "uncertainty": "The instrument in the left hand cannot be identified - only a shiny flat shank is visible. Which side of the jaw is in the frame (left/right) cannot be determined unambiguously from this lateral view. Unidentified objects in the frame: a flat metal instrument in the left hand (only the shank and part of the working end are visible) - a scalpel and an elevator cannot be told apart in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0012",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 149.2,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 143.98,
     "category": "observation",
     "statement": "There's another release incision there."
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "overview of the anterior mandibular crest between steps, all instruments out of the mouth",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "mandibular teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "keeps the field open while instruments are out of the mouth",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The instruments have been withdrawn, giving an overview of the anterior part of the crest: a short incision line with blood is visible in the anterior segment. The surgeon deliberately leaves such 'clean' frames - they show the state of the tissues between steps.",
   "L5_clinical_context": "Anterior segment of the mandible: the crest is narrow, the mucosa is thin, and the tongue lies against the incision line on the lingual side. This is exactly why the surgeon will start the elevation on the lingual side - the tissue tears there most easily.",
   "uncertainty": "There are no instruments in the frame, no movement can be annotated. The extent of the incision is visible only in the anterior segment; the lateral segments are hidden by the lip and the tongue.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0025",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 292.2,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 269.3,
     "statement": "Okay, so good, so this other section here, I'm going to use a gauze to get rid of the",
     "category": "technique"
    },
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "End of flap elevation: inter-step pause with instruments withdrawn from the mouth while the field is prepared for the switch to the surgical burr for ridge smoothing.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "upper lip",
    "maxillary teeth",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds the metal retractor blade at the mouth entrance while instruments are exchanged",
     "metal retractor blade"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "remains in place holding the lips open between steps",
     "upper lip"
    ]
   ],
   "L4_reasoning": "This frame was captured 7 seconds before the remark about transitioning to smoothing the ridge with the burr, i.e. it is an inter-step pause: the instruments have been withdrawn from the mouth, and the surgeon's and assistant's hands are at the entrance to the oral cavity. Technically this is the end of the incision-and-flap phase - reflection has been declared finished ('dissect clean'), and the field is being prepared for the instrument change to the surgical burr. No substantive surgical action inside the wound is occurring at this moment.",
   "L5_clinical_context": "At the junction between reflection and alveoloplasty two things matter: the flap must be retracted and protected from the rotating instrument, and the bony ridge must be dry and visible. Changing instruments away from the wound reduces the risk of accidentally touching the soft tissue or contaminating the field. Next, the burr is used to smooth the sharp edges of the ridge, working between the mental foramina and monitoring depth so as not to remove excess bone height, since it is needed for the 16 mm osteotomies for 4.3x13 mm implants.",
   "uncertainty": "This frame is practically unusable for annotating the surgical content: the assistant's hand blocks the mouth entrance, and the wound is not visible at all. What exactly is being done with the instrument near the retractor (wiping it, handing it over, loading it with gauze) cannot be determined from the frame. The fluted-handle instrument is assigned to periosteal elevator by continuity with the neighboring frames, not from this image itself. The dental arch visible through the OptraGate ring is interpreted as the upper arch, but the angle is obstructed and there is no certainty about this; natural teeth cannot be distinguished from crowns/restorations. The nasal cannula is not in frame. Unidentified objects in the frame: instrument exchange/handoff outside the mouth - a thin instrument brought to the working surface of the metal retractor, the nature of the action cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0028",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 293.8,
   "phase_index": 1,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 269.3,
     "statement": "Okay, so good, so this other section here, I'm going to use a gauze to get rid of the",
     "category": "technique"
    },
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "milestone"
    },
    {
     "time": 239.46,
     "statement": "This is another mental nerve on the right side and now I'm going to pick up that periosteum",
     "category": "anatomy"
    }
   ],
   "L1_phase_normalized": "incision_and_flap",
   "L1_phase_detailed": "flap reflection completed on both sides, edentulous mandibular crest fully exposed, immediately before ridge smoothing",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "cortical bone",
    "mucoperiosteal flap",
    "tongue",
    "gingiva",
    "keratinized gingiva",
    "oral mucosa",
    "lower lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the labial flap and lower lip downward to fully expose the alveolar crest",
     "mandibular alveolar ridge"
    ],
    [
     "gloved hand",
     "holds the retractor steady while the surgeon inspects the exposed bone",
     "metal retractor blade"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "keeps the lips and cheeks retracted for the overhead view of the exposed ridge",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The end of the phase (98% of its duration): the mucoperiosteal flap is reflected on both sides, the edentulous mandibular ridge is exposed - a light bone surface with blood smears is visible in the frame, the lingual flap is retracted upwards together with the tongue, the buccal one is pressed downwards by the retractor. Exactly at this moment comes the surgeon's remark that the dissection is clean and that one can move on to smoothing the ridge with a burr. The frame records the state of the field before the change of phase: next come alveoloplasty/smoothing and the marking of the osteotomies.",
   "L5_clinical_context": "The exposed mandibular ridge after reflection of the flap is usually uneven, with sharp bony projections left after the loss of the teeth; they are smoothed with a burr in order to obtain a flat platform for the osteotomies and for the future prosthetic platform, and also so that the flap lies over the sharp edges without tension. The width and height of the bone after smoothing determine whether 4.3x13 mm implants can be placed with an osteotomy 16 mm deep. The limits of the work are still set by the mental foramina: the smoothing and the subsequent osteotomies are performed in the interforaminal zone and anterior to the nerve. The exposed bone must be kept under irrigation and must not be allowed to dry out.",
   "uncertainty": "Cortical and cancellous bone cannot be separated from the frame: the surface is flooded with blood, only a general light bony platform is visible. The mental foramina cannot be made out in the frame although the flap is reflected - they are either covered by blood or outside the field. The instrument at the lower left edge is visible fragmentarily, it cannot be determined. The burr the surgeon speaks about 5 s later has not yet got into this frame, which is why the handpiece was not listed in L2. The suction tip is not visible in the frame although it was working seconds earlier. Unidentified objects in the frame: a thin metal instrument at the lower left edge of the frame, only its edge is visible - the type cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0029",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 300.0,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    },
    {
     "time": 269.3,
     "statement": "Okay, so good, so this other section here, I'm going to use a gauze to get rid of the",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "transition from subperiosteal dissection to ridge smoothing, before the burr work begins",
   "L2_instruments": [
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa",
    "lower lip",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "finishing the subperiosteal dissection before starting the smoothing",
     "mucoperiosteal flap"
    ],
    [
     "metal retractor blade",
     "holding the cheek and flap away from the working field",
     "oral mucosa"
    ],
    [
     "gauze",
     "wiping the field clean",
     "gingiva"
    ]
   ],
   "L4_reasoning": "Junction between steps: the subperiosteal dissection is finished, the field is being wiped with gauze, and the transition to ridge smoothing is beginning. The surgeon states directly: \"dissect clean\" -- and announces he is about to pick up the burr. This frame is the moment right before the burr work starts.",
   "L5_clinical_context": "Mandible, All-on-4: to obtain a level prosthetic bed, the ridge must be freed from the flap along its full working length and cleared of blood and tissue debris. The retractor and gauze provide visibility and prevent injury to the cheek and tongue during the subsequent rotation of the burr.",
   "uncertainty": "The frame is almost completely occluded by the surgeon's hands; the working field is not visible. The instrument in the hand is identified by silhouette (a long metal handle with a flat working end) as a periosteal elevator -- a scalpel handle cannot be ruled out. The exact area of work cannot be determined from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0026",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 301.8,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 269.3,
     "statement": "Okay, so good, so this other section here, I'm going to use a gauze to get rid of the",
     "category": "technique"
    },
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty setup: anterior mandibular ridge exposed under the reflected flap, field blotted with gauze immediately before crest smoothing begins.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "chin"
   ],
   "L3_triplets": [
    [
     "gauze",
     "blot and clean the exposed crest before smoothing",
     "mandibular alveolar ridge"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "hold the lips and cheeks clear of the field",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "Transition moment from flap reflection to alveoloplasty: the surgeon has just said the dissection is finished and the field is clean, and is about to take up the burr for smoothing. The frame captures the field's 'before' state: the crest is exposed, the flap is retracted, and blood is being wiped with gauze so the bone contour can be seen and the extent of reduction judged.",
   "L5_clinical_context": "Mandible, exposed alveolar ridge under a full-thickness mucoperiosteal flap. Before All-on-4, the ridge is leveled to create a flat bony bed for the future prosthetic platform and to remove sharp edges that would injure the flap. The main risk landmarks in this area are the mental foramina and the emerging nerve; their position is not visible on this lateral view, so reduction is carried out under visual control of the retracted flap. In the maxilla, preserved teeth with a gold crown are visible - the antagonists that set the vertical dimension.",
   "uncertainty": "The burr has not yet appeared in frame; the image alone cannot confirm whether smoothing has started - the phase inference relies on speech. The dark object in the assistant's hand near the corner of the mouth is not identifiable (could be a handpiece head, a suction tip, or a mirror). There is no diarization, so attribution of the quote to a specific speaker was not verified. Unidentified objects in frame: a dark object in the assistant's blue glove near the corner of the mouth - not identifiable from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0030",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 302.0,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "baseline overview of the exposed mandibular ridge before smoothing begins",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "tongue",
    "lower lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracting the tongue away from the mandibular ridge",
     "tongue"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "keeping the lips and cheeks open for the overhead view",
     "lower lip"
    ]
   ],
   "L4_reasoning": "An overview frame right after the statement about being ready for smoothing: the field is prepared, the flap is reflected, and the mandibular ridge is exposed along its whole frontal extent. This frame serves as the baseline state of the ridge, against which the result of the reduction will later be compared.",
   "L5_clinical_context": "The edentulous mandibular ridge is visible with the mucoperiosteal flap reflected and traces of bleeding along the incision line. At the top of the frame are the maxillary teeth with metal crowns. The safety landmark in the anterior region is the mental foramina with the neurovascular bundle, which must not be injured during ridge reduction.",
   "uncertainty": "The bone at the crest and the pale edges of the flap cannot be reliably distinguished in this frame -- the exposed cortical plate cannot be told apart from the pale flap tissue. The dark blade in the frame is interpreted as a retractor with a black coating, but by silhouette it could be a different instrument.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0027",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 304.4,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty setup: buccal flap retracted with a blade to expose the full anterior mandibular crest immediately before burr work.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [
    "a second retractor blade of the same type lies in the surgeon's left hand outside the mouth"
   ],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retract the mucoperiosteal flap and expose the crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Access preparation immediately before working with the burr: a blade retracts the buccal flap so the entire crest is in direct view and the rotating instrument will not catch the soft tissue. The surgeon is holding a second blade ready - the field will need to be opened wider as work progresses along the crest.",
   "L5_clinical_context": "Lateral view: visible are the nasal cannula (sedation with oxygen supply), the OptraGate holding the lips and cheeks, and the exposed mandibular ridge with a bleeding wound surface. Retracting the flap with the metal blade both protects the soft tissue from the burr and prevents the mucosa from wrapping around the rotating instrument.",
   "uncertainty": "The type and size of the blade cannot be determined from the frame. How far distally the flap is retracted, and whether the area near the mental foramen is already visible, cannot be assessed from this angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0028",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 310.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty, instrument hand-off: an object is being brought toward the mouth while the assistant's hand blocks the field.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "nose",
    "chin",
    "oral mucosa"
   ],
   "L3_triplets": [],
   "L4_reasoning": "The working field in this frame is entirely blocked by the assistant's hand as it brings an instrument toward the mouth. Substantively the frame only captures the moment an instrument is being handed off/introduced within the crest-smoothing phase; no clinical action can be confirmed from it.",
   "L5_clinical_context": "Only the outer part of the surgical field is visible: the patient's nasal oxygen cannula under sedation and the edge of the OptraGate. No intraoral anatomy is legible in this frame.",
   "uncertainty": "The surgical field is not visible - the assistant's hand covers the mouth. The dark object near the corner of the mouth is not identifiable; there are no grounds from the image to assume it is a handpiece or a suction tip. The retractor blade in the upper left corner is recognizable by shape but is located outside the mouth. Unidentified objects in frame: a dark metal object near the corner of the mouth, partially covered by the hand - cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0031",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 311.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "ridge exposure check with a periosteal elevator lifting the flap before burr work, both retractors in place",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "cortical bone",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "holding the flap and the cheek open on both sides",
     "mucoperiosteal flap"
    ],
    [
     "periosteal elevator",
     "lifting the flap off the bone to expose the crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The field is retracted with two retractors and the ridge is exposed -- the surgeon is checking the extent of exposure before turning on the burr. The instrument in the center is lifting the flap so that the entire bony ridge to be smoothed becomes visible.",
   "L5_clinical_context": "The white bony ridge of the mandible is clearly visible with an irregular, sharp edge -- a typical indication for alveoloplasty prior to implant placement. The flap has been reflected down to the periosteum along its full depth; when reflecting further posteriorly it is critical not to encroach on the mental foramen.",
   "uncertainty": "The central instrument with a narrow flat end is identified as a periosteal elevator by its shape -- a different model of raspatory or a wide flat instrument (plugger) cannot be ruled out from this frame. The speech does not name it.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0029",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 312.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty setup: continued opening of access along the vestibular ridge, flap and soft tissue held back before reduction.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retract the flap and keep the crest in view",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "Continued opening of access before crest reduction: the blade holds the flap while the assistant's hand supports the soft tissue on the opposite side. Blood on the crest shows this is a fresh wound surface from flap reflection, not a result of burr work yet.",
   "L5_clinical_context": "The vestibular surface and the apex of the mandibular alveolar ridge are exposed. At this stage it is important to hold the flap without tension: over-retraction tears the periosteum and worsens later wound closure over the implants.",
   "uncertainty": "Exactly what the thin metal tip visible near the crest is - a suction tip, a probe, or a second retractor - cannot be determined from the frame. The right side of the field is blocked by the assistant's dark blue glove. Unidentified objects in frame: a thin metal tip near the crest to the right of the blade - seen only fragmentarily, the instrument is not identified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0032",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 321.2,
   "phase_index": 2,
   "image_quality": "degraded",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "blurred handoff moment between the smoothing announcement and the first burr contact; no distinct step visible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa",
    "tongue",
    "blood"
   ],
   "L3_triplets": [],
   "L4_reasoning": "The frame is blurred by camera or patient motion, and no meaningful action can be extracted from it. It falls in the interval between the statement about starting the smoothing and the first activation of the burr -- by timing this corresponds to preparation / instrument hand-off.",
   "L5_clinical_context": "Only the retractor ring, the tongue, and blood in the field can be made out; the anatomical landmarks of the mandible are not legible in this frame.",
   "uncertainty": "The frame is marked as degraded and is almost completely blurred: neither the instruments nor the area of work can be reliably determined. The retractor is identified only by the recognizable silhouette of the blade on the right; everything else is unreliable.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0030",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 322.0,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty, pause within the sequence: field held open with the cheek retracted, no active burr work at the moment of capture.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "oral mucosa",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "hold the cheek and flap away from the crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "A frame from a pause within the phase: the field is held open, with no active burr work at the moment of capture. Such intervals are needed to assess how much bone still needs to be removed and to reposition retraction before the next pass.",
   "L5_clinical_context": "Lateral view of the mandible with the cheek retracted. The crest apex and the upper antagonist teeth are visible; it is precisely the relationship to the antagonists that determines how far the ridge may be reduced while leaving room for the prosthetic construction.",
   "uncertainty": "The frame is strongly underexposed, and intraoral details are lost in shadow. Instruments other than the retractor blade are not identifiable. Whether smoothing is happening right now cannot be told from the image. Unidentified objects in frame: a dark elongated rod/tube crossing the frame above the surgeon's hand - the silhouette does not distinguish whether it is a suction tip, a handpiece hose, or a shadow.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0031",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 324.0,
   "phase_index": 2,
   "image_quality": "degraded",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty, silent technical pause: anterior crest and tongue held retracted with no burr in frame.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "tongue",
    "blood",
    "lower lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retract the lip and cheek to expose the mandibular crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "There is no speech within the +/-5 s window: this is a technical pause within the crest-smoothing phase, the field is held open, and no burr is visible in frame. The phase is confirmed by its position in time and the ongoing retraction of the same site.",
   "L5_clinical_context": "The tongue is visible, pushed posteriorly, along with the exposed anterior mandibular ridge. During mandibular work the tongue is a constant obstruction and a source of injury risk from the rotating instrument, so it must be retracted along with the flap for the entire duration of reduction.",
   "uncertainty": "The frame is flagged as degraded and is indeed dark: the bone contour and the extent of smoothing already performed are not legible. There is no speech nearby; the content of the action is reconstructed only from the phase context.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0032",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 329.4,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 329.28,
     "statement": "Now we're going to do this, so ideally what you want to have is something from here, you",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty planning: surgeon indicating the intended extent of ridge reduction along the anterior mandibular crest before cutting begins.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retract the flap and demonstrate the extent of the crest",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The surgeon comments on the extent of the upcoming work ('ideally what you want to have is something from here...'), using the blade to indicate the length of the ridge segment that should result after reduction. The frame captures a moment of planning the alveoloplasty boundaries, not cutting.",
   "L5_clinical_context": "Exposed mandibular ridge, retracted flap, tongue pushed posteriorly. The planned extent of leveling is dictated by the future position of the five implants and should produce a flat plateau without steps between the anterior and lateral segments.",
   "uncertainty": "Exactly what the surgeon is pointing to with 'from here' cannot be reconstructed from the frame: the gesture is out of this camera's field of view. The quote is cut off mid-sentence; its continuation is not in this window.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0036",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 331.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 329.28,
     "statement": "Now we're going to do this, so ideally what you want to have is something from here, you",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "pause in ridge work while discussing camera positioning; general view of the patient's face with the nasal cannula",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "nose",
    "lower lip",
    "tongue",
    "oral mucosa",
    "gingiva",
    "mandibular alveolar ridge",
    "blood"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "keeping the mouth open for the overhead camera",
     "lower lip"
    ],
    [
     "nasal oxygen cannula",
     "delivering oxygen during sedation",
     "nose"
    ]
   ],
   "L4_reasoning": "A pause in the work: the instruments have been withdrawn from the field, and at this moment the surgeon is discussing camera placement (the remark about where best to film from). The frame captures a general view of the patient and allows the field to be anchored to the face.",
   "L5_clinical_context": "A nasal oxygen cannula is visible -- the operation is being performed under sedation, and the patient's breathing is being supported. The mouth is held open by the OptraGate retractor; in the lower part of the frame, blood is visible along the incision line on the mandibular ridge.",
   "uncertainty": "The working field is almost not visible -- the ridge runs off the bottom edge of the frame and is obscured by the tongue. The remark in the window relates to the organization of filming, not to a surgical action; exactly what action is being performed at this moment cannot be determined from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0033",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 334.0,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 329.28,
     "statement": "Now we're going to do this, so ideally what you want to have is something from here, you",
     "category": "surgical_plan"
    },
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty, active crest smoothing begins: burr on the handpiece brought to the ridge apex of the anterior mandible under irrigation.",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical burr",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "irrigation line",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "surgical handpiece (contra-angle)",
     "drive the burr against the bone under irrigation",
     "mandibular alveolar ridge"
    ],
    [
     "surgical burr",
     "grind down and smooth the crest",
     "mandibular alveolar ridge"
    ],
    [
     "irrigation line",
     "cool the bur and the bone during cutting",
     "cortical bone"
    ]
   ],
   "L4_reasoning": "Start of the actual smoothing: the handpiece with the burr has been brought into the mouth, its working end positioned at the ridge apex. The surgeon named the instrument earlier ('use this burr to smooth the ridge'), so this is specifically a bone-shaping burr, not an osteotomy drill. Irrigation is connected - bone cutting is proceeding under cooling.",
   "L5_clinical_context": "Work at the apex of the mandibular alveolar ridge. The key requirement is continuous cooling: overheating cortical bone above roughly 47 C causes thermal necrosis and subsequent loss of primary implant stability. The danger zone laterally is the mental foramina with the emerging neurovascular bundle, so reduction proceeds from the crest downward and does not extend onto the vestibular surface.",
   "uncertainty": "The shape of the burr's working end in this frame is blurred and obscured; distinguishing a bone-shaping burr from a drill cannot be done from the image - the term is taken from the surgeon's speech. The actual depth of bone removal cannot be measured from this lateral angle. Whether irrigation is actively flowing at this moment (only the outline of the green line is visible) cannot be confirmed from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0037",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 335.6,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 329.28,
     "statement": "Now we're going to do this, so ideally what you want to have is something from here, you",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "first burr pass smoothing the sharp crest of the mandibular ridge, handpiece entering from the left",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical burr",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "cortical bone",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "tongue",
    "lower lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "surgical burr",
     "smoothing the sharp crest of the alveolar ridge",
     "mandibular alveolar ridge"
    ],
    [
     "surgical handpiece (contra-angle)",
     "driving the burr along the crest",
     "cortical bone"
    ],
    [
     "metal retractor blade",
     "holding the tongue and the flap clear of the rotating burr",
     "tongue"
    ]
   ],
   "L4_reasoning": "The first clear working contact of the burr: the handpiece is brought in from the left, and the round burr head is running along the ridge -- exactly what the surgeon announced with the remark \"use this burr to smooth the ridge.\" The smoothing is done before the osteotomies are formed, so that the implants are placed in a level bed and the prosthesis does not traumatize the mucosa over sharp projections.",
   "L5_clinical_context": "The burr is working on the cortical plate of the mandibular ridge with the flap reflected. Risks at this step: overheating of the bone without irrigation, the burr slipping onto the tongue or the flap, and, in the posterior regions, the proximity of the mental foramen. The retractor and holding the tongue back are mandatory protection while the rotary instrument is running.",
   "uncertainty": "The type of burr (round, ovoid, Lindemann) cannot be determined from the frame -- the speech only says \"burr.\" Irrigation delivery is not visible in the frame: whether cooling is running cannot be said. The suction tip is hidden; only the white tubing is visible.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0034",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 336.0,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": 1,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 329.28,
     "statement": "Now we're going to do this, so ideally what you want to have is something from here, you",
     "category": "surgical_plan"
    },
    {
     "time": 299.28,
     "statement": "dissect clean, and we're ready to do the smoothing. So we're gonna use this burr to smooth the ridge a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "Alveoloplasty, active burr pass along the anterior mandibular crest with flap and tongue protected by the retractor blade.",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical burr",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "nose"
   ],
   "L3_triplets": [
    [
     "surgical burr",
     "reduce and smooth the crest of the ridge",
     "mandibular alveolar ridge"
    ],
    [
     "metal retractor blade",
     "protect the flap and the tongue from the rotating burr",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The active smoothing pairing: the surgeon runs the burr along the crest while the assistant holds the flap and tongue back with the blade so the rotating instrument does not catch the soft tissue. The simultaneous presence of the handpiece and the retractor in the same frame confirms that reduction is happening right now.",
   "L5_clinical_context": "Mandibular ridge, the vestibular flap retracted, the tongue pushed medially. In mandibular reduction the most common iatrogenic injury is the mucosa or tongue catching on the burr, so protecting the soft tissue with the metal blade is mandatory throughout the pass.",
   "uncertainty": "The point of burr application and the volume of bone being removed cannot be assessed from this angle. The instrument in the assistant's hand on the right is not identifiable. The type of the burr's working end is not visually distinguishable - a generalization from the surgeon's speech is used. Unidentified objects in frame: a dark instrument in the assistant's hand in the upper right corner - not identifiable from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0048",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 436.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 434.02,
     "statement": "That's why I'm going to use this, you know, one more view, for my own.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "clearest bone rongeur trimming of the crest at the front of the ridge, gauze held ready",
   "L2_instruments": [
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "bone rongeur",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "cortical bone",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "tongue",
    "lower lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "bone rongeur",
     "trimming the bone at the crest of the ridge",
     "mandibular alveolar ridge"
    ],
    [
     "gauze",
     "kept in the field for wiping bone debris",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The clearest frame showing bone nipping: the instrument's jaws are pressed against the bony edge of the ridge, with gauze ready alongside. This is how projections that would take longer to grind down with the burr are removed.",
   "L5_clinical_context": "The work is on the anterior segment of the mandibular ridge with the flap reflected; bone debris from previous burr passes lies on the tongue and mucosa. Only bone must be grasped -- catching the flap causes a tear and makes suturing worse.",
   "uncertainty": "The speech does not name the instrument. Identification as bone rongeurs is based on the shape of the hinged jaws. The object in the right hand (a gray cylinder with a rim) is not identified: it could be a handpiece body, a retractor, or another instrument. Unidentified objects in the frame: a gray metal instrument body in the right hand -- cannot be identified from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0056",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 440.8,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 434.02,
     "statement": "That's why I'm going to use this, you know, one more view, for my own.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "alveoloplasty, visual check of the ridge profile between working passes, anterior mandible",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "oral mucosa",
    "blood",
    "lower lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the lip and flap to expose the whole ridge for inspection",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "A check inspection of the crest between working passes: there are no instruments on the bone, the field is open and rinsed, and the surgeon is looking at the whole profile of the crest. It is during pauses like this that decisions are made about where more bone still needs to be removed and where enough has already been taken.",
   "L5_clinical_context": "The anterior segment of the edentulous mandible is visible, the flap is reflected buccally, and the crest is wet with blood and irrigation fluid. The landmark is the evenness of the ridge line and the absence of sharp prominences on palpation; in the lateral segments the safety landmark is the mental foramina.",
   "uncertainty": "The nearby speech relates to viewing, not to a manipulation — exactly what the surgeon is assessing does not follow from the frame. There are no instruments in the wound, so the current action can only be judged from the phase.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0064",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 549.2,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "end of alveoloplasty / start of osteotomy, first drill entering the crest of the anterior mandibular ridge to establish the entry point and axis",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant drill",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "osteotomy site",
    "cortical bone",
    "tongue",
    "lower lip",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "implant drill",
     "enters the crest of",
     "mandibular alveolar ridge"
    ],
    [
     "surgical handpiece (contra-angle)",
     "drives the drill into",
     "osteotomy site"
    ],
    [
     "irrigation line",
     "irrigates and cools",
     "osteotomy site"
    ],
    [
     "metal suction tip",
     "evacuates irrigation fluid and",
     "blood"
    ]
   ],
   "L4_reasoning": "The surgeon comments directly: \"with this first drill... this first drill is going to give it a little bit of volume\". This is the end of alveoloplasty and the actual start of osteotomy site formation: the first drill only marks the entry point and axis, and the volume for the 4.3 mm implant will be widened with subsequent diameters.",
   "L5_clinical_context": "The last frame of the phase (position_in_phase 0.99): osteotomy follows. Landmarks for the first drill are the leveled ridge as the reference plane, the cortical plate from which the surgeon measures, and the target depth of 16 mm for a 13 mm implant (confirmed by the statement at 586.2 s). The risk when entering dense cortical bone is drill slippage and bone overheating without irrigation; more distally lie the mental foramen and mental nerve.",
   "uncertainty": "The type of the first drill (pilot drill vs. twist drill) is not named by the surgeon — a generic term is used. The working part at depth is hidden by tissue and the assistant's fingers; the actual depth of penetration is not measurable from the frame; which of the five sites is being prepared is not determinable. The phase is formally left as alveoloplasty per the batch boundary, although by speech osteotomy has already begun here.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0073",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 549.4,
   "phase_index": 2,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "alveoloplasty",
   "L1_phase_detailed": "alveoloplasty/osteotomy transition, first drill positioned on the smoothed crest, anterior mandible",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant drill",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "blood",
    "oral mucosa",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "implant drill",
     "is positioned on the smoothed crest to start the osteotomy",
     "mandibular alveolar ridge"
    ],
    [
     "surgical handpiece (contra-angle)",
     "drives the drill under irrigation",
     "implant drill"
    ],
    [
     "metal retractor blade",
     "retracts the flap for direct vision of the crest",
     "mucoperiosteal flap"
    ],
    [
     "metal suction tip",
     "aspirates irrigation fluid and blood at the crest",
     "blood"
    ]
   ],
   "L4_reasoning": "The last frame of the phase: the crest is smoothed, the handpiece with the drill is positioned on the crest, and the surgeon announces the first drill out loud — this is the junction between the alveoloplasty and the osteotomy. The first drill sets the entry point and the axis that all subsequent drills will follow; that is why it is placed only after the bony platform is even.",
   "L5_clinical_context": "Anterior segment of the edentulous mandible, flap reflected, irrigation connected to the handpiece. Per the case protocol, the osteotomy is carried out to a depth of 16 mm at 1200 rpm for 4.3 x 13 mm implants. The critical landmarks are the midline, the mental foramina, and the anterior loop of the inferior alveolar nerve: the tilt and entry point in the anterior segment are chosen so that the lateral osteotomies remain medial to the foramen mentale.",
   "uncertainty": "Exactly which drill is mounted in the handpiece (pilot, twist, or the next one per protocol) cannot be determined from the frame — the surgeon only says \"this first drill\". The phrase \"give it a little bit of volume\" sounds atypical and may be a transcription inaccuracy; it is not in the case's known errors, so the quote is left verbatim. The phase is formally still alveoloplasty (boundary at 540 s), but in fact this is already the start of the osteotomy. Unidentified objects in the frame: a curved metal instrument with a round end above the field — a mirror or a second retractor, cannot be distinguished with certainty.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0074",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 557.6,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, first drill starting the initial pilot channel, anterior mandible near the mental foramen area",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "oral mucosa",
    "lower lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "pilot drill",
     "drill",
     "mandibular alveolar ridge"
    ],
    [
     "metal retractor blade",
     "retract",
     "lower lip"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retract",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon announces the start of drilling: 'with this first drill now' — the first drill, in his words, gives 'a little bit of volume, ability to guide,' i.e. it creates an initial volume and a guide channel for the subsequent drills. The cooled handpiece has been inserted into the mouth; the assistant holds the retractor and the suction tip.",
   "L5_clinical_context": "Lower jaw (mandible), All-on-4 (per case_facts — 5 implants 4.3x13 mm, osteotomy to 16 mm, 1200 rpm). Work is taking place in the inter-mental region; the key risk is the mental foramen and the mental nerve, which the surgeon mentions about 26 seconds later. Cooling via the irrigation line is mandatory to prevent thermal bone necrosis.",
   "uncertainty": "The drill type (pilot vs. twist) cannot be distinguished from the frame — it is labeled generically as 'implant drill'; the surgeon only calls it the 'first drill.' The ridge and the osteotomy site are obscured by the handpiece head and fingers. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0065",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 575.0,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 598.24,
     "statement": "to this cortical bone and we're going to drill to 16 and intention is to place",
     "category": "measurement"
    },
    {
     "time": 603.0,
     "statement": "implant number 13 on there",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, first drill establishing access and axis in the mandibular ridge, target depth 16 mm for implant site 13",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "osteotomy site",
    "tongue",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "pilot drill",
     "drills into",
     "mandibular alveolar ridge"
    ],
    [
     "surgical handpiece (contra-angle)",
     "drives drill in",
     "osteotomy site"
    ],
    [
     "metal suction tip",
     "suctions",
     "blood"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon explains that the first drill 'gives it a little bit of volume' and the ability to guide direction — that is, it sets the starting point and axis of the future site. In the same breath he states the preparation goal: drill to 16 mm and place implant #13.",
   "L5_clinical_context": "Mandible, All-on-4, edentulous alveolar ridge, flap reflected, access through the OptraGate. The landmark the surgeon names aloud is the crestal cortical bone: the drill should run parallel to it. Protocol depth is 16 mm for a 13 mm implant. The main risk in this area is the mental foramen / mental nerve, which the surgeon discusses in the adjacent segments.",
   "uncertainty": "The frame does not allow determining exactly which drill is mounted in the handpiece (pilot / twist / next diameter) — the vocabulary distinguishes these types, but only the working part is visible in the frame. The speech calls it 'this first drill', but 21 s elapsed between the quote (541.98) and the frame (563.0). Which site position is being prepared cannot be determined from the frame. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0075",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 575.2,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, pause between passes of the first drill, flap retracted to expose the ridge crest",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "blood",
    "oral mucosa",
    "lower lip",
    "upper lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retract",
     "mucoperiosteal flap"
    ],
    [
     "metal suction tip",
     "aspirate",
     "blood"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retract",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Pause between drill passes: the instrument has been withdrawn from the bone; a wide metal blade is being brought to the incision line to retract the flap and expose the ridge for the next drill. The speech in this window still refers to the same 'first drill.'",
   "L5_clinical_context": "A linear incision is visible along the mandibular ridge with the mucoperiosteal flap reflected and moderate bleeding. The exposed ridge is the working surface for the osteotomies; flap retraction is needed for direct visualization of the cortical plate, which the surgeon later uses to set parallelism.",
   "uncertainty": "The flat, wide blade is labeled metal retractor blade; by its shape it could also be a periosteal elevator — this is not confirmed by speech. The lower lip/upper lip distinction in this frame is approximate (the face is shot from the side, and the lips are held by the OptraGate).",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0076",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 580.8,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 583.96,
     "statement": "ability to guide so you can see this is the nerve and we're doing our first and",
     "category": "safety"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, first drill phase, surgeon pointing out the mental nerve as a landmark",
   "L2_instruments": [
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "mental nerve",
    "blood",
    "dental crown (existing restoration)",
    "oral mucosa",
    "lower lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal suction tip",
     "aspirate",
     "blood"
    ],
    [
     "gloved hand",
     "retract",
     "lower lip"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retract",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The surgeon demonstrates the anatomy to the camera: 'you can see this is the nerve' — he points out the nerve as a landmark and explains that the first drill gives direction ('ability to guide'). A finger retracts the lip, the suction tip clears blood, so the field is visible on the recording.",
   "L5_clinical_context": "Demonstration of the mental nerve — a key safety moment: All-on-4 osteotomies in the mandible are placed anterior to the mental foramen, with the distal ones angled to avoid the nerve. Injury causes persistent paresthesia of the lower lip and chin.",
   "uncertainty": "The mental nerve is recorded based on the surgeon's direct statement ('this is the nerve'), not because I can confidently see it in the frame. The crown on the right is classified as dental crown (existing restoration); whether it belongs to the upper or lower arch cannot be determined from this angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0066",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 584.2,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 583.96,
     "statement": "ability to guide so you can see this is the nerve and we're doing our first and",
     "category": "anatomy"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, first drill pass, surgeon points out the mental nerve near the site",
   "L2_instruments": [
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "mental foramen",
    "mental nerve",
    "gingiva",
    "lower lip",
    "chin",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon interrupts drilling to point out the nerve to the camera: 'you can see this is the nerve.' This landmark is shown during the first drill pass — the position of the nerve is exactly what determines where preparation can proceed.",
   "L5_clinical_context": "The frame is captured at the moment the surgeon points to the neurovascular bundle in the mental foramen area. The mental foramen / mental nerve is the key limiting landmark for the distal extent of mandibular osteotomies in All-on-4: implants are placed anterior to the foramen, with the posterior ones tilted. The ridge is exposed, the flap reflected, and the ridge mucosa is visible.",
   "uncertainty": "The surgeon says 'this is the nerve,' but the frame does not allow pinpointing exactly which dark structure he is pointing to (the neurovascular bundle at the mental foramen or a blood clot). The side (left/right mental foramen) cannot be determined. The drill is visible only partially, at the top edge of the frame, and its type is not distinguishable. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0077",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 585.6,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 583.96,
     "statement": "ability to guide so you can see this is the nerve and we're doing our first and",
     "category": "safety"
    },
    {
     "time": 590.56,
     "statement": "this is a second drill I'm sure it's for that mental parameter",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, second drill entering the site for implant position #13, keeping the axis parallel to the cortical bone, target depth 16 mm",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "mental nerve",
    "blood",
    "oral mucosa",
    "lower lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "pilot drill",
     "drill",
     "osteotomy site"
    ],
    [
     "surgical handpiece (contra-angle)",
     "drive",
     "osteotomy site"
    ],
    [
     "metal retractor blade",
     "retract",
     "mucoperiosteal flap"
    ],
    [
     "irrigation line",
     "irrigate",
     "cortical bone"
    ]
   ],
   "L4_reasoning": "Drill change: 'this is a second drill' — a second pass is being made through the already-marked channel. The surgeon then states the direction criterion: stay parallel to the bone and go to 16 mm for implant #13.",
   "L5_clinical_context": "The direction landmark is the cortical plate of the ridge ('I want to stay parallel to this bone right there, to this cortical bone'). A depth of 16 mm for a 13 mm implant gives a margin; in the anterior mandible the bone is dense (D1-D2), so cooling and sequential widening of the channel are mandatory.",
   "uncertainty": "'mental parameter' in the transcript is almost certainly a distortion (the known-error list has 'mempal foramina' → 'mental foramina', but this exact form is not in the list) — the quote is left verbatim. Pilot vs. twist for the 'second drill' is not visually confirmed. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted. Note the tension with L1_phase_detailed above, which reads this frame as the second drill: that was the annotator's own reading of the image, while the 'this is a second drill' line is only spoken at 578.56 s, after this frame. The pilot drill label follows the narration window; L1_phase_detailed is left exactly as the annotator wrote it.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0067",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 586.8,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 583.96,
     "statement": "ability to guide so you can see this is the nerve and we're doing our first and",
     "category": "anatomy"
    },
    {
     "time": 590.56,
     "statement": "this is a second drill I'm sure it's for that mental parameter",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, transition to the second drill near the mental foramen landmark",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "tongue",
    "lower lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "surgical handpiece (contra-angle)",
     "positioned over",
     "mandibular alveolar ridge"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon moves on to the second drill and ties the choice to the landmark at the mental foramen ('I'm sure it's for that mental parameter' — contextually this refers to the mental foramen). In other words, the change of drill and position is dictated by the proximity of the nerve.",
   "L5_clinical_context": "Change to the next drill in the sequence, in an area bounded by the mental foramen. Sequential widening of the site with progressively larger-diameter drills is standard protocol; at 1200 rpm, external irrigation is mandatory to avoid overheating the bone.",
   "uncertainty": "The frame is heavily blurred and almost half occluded by the assistant's glove — the surgical field cannot be made out, and the instrument in the center of the frame is not identifiable. The segment 'I'm sure it's for that mental parameter' is clearly a mis-transcription; it is not among the known_transcription_errors, but contextually it most likely refers to the mental foramen/foramina — the quote has been kept verbatim. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted. Note the tension with L1_phase_detailed above, which reads this frame as the second drill: that was the annotator's own reading of the image, while the 'this is a second drill' line is only spoken at 578.56 s, after this frame. The pilot drill label follows the narration window; L1_phase_detailed is left exactly as the annotator wrote it.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0078",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 587.6,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": 2,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 553.98,
     "statement": "So with this first drill now, this first drill is going to give it a little bit of volume,",
     "category": "technique"
    },
    {
     "time": 583.96,
     "statement": "ability to guide so you can see this is the nerve and we're doing our first and",
     "category": "safety"
    },
    {
     "time": 590.56,
     "statement": "this is a second drill I'm sure it's for that mental parameter",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, second drill seated in the osteotomy for implant position #13, maintaining axis parallel to the cortical bone at 16 mm depth",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "pilot drill",
     "confidence": "probable",
     "source": "both",
     "identified_by": "drill_protocol_2026-08-05"
    },
    {
     "name": "irrigation line",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "mental nerve",
    "blood",
    "oral mucosa",
    "lower lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "pilot drill",
     "drill",
     "osteotomy site"
    ],
    [
     "metal retractor blade",
     "retract",
     "mucoperiosteal flap"
    ],
    [
     "metal suction tip",
     "aspirate",
     "blood"
    ]
   ],
   "L4_reasoning": "The second drill is seated in the osteotomy; at this moment the surgeon states the requirement for the axis — parallel to the cortical bone, depth of 16 mm, for implant #13. The drill with depth markings is visible right at the ridge crest.",
   "L5_clinical_context": "Parallelism of the osteotomies to each other and to the cortical plate is critical: axis divergence will prevent seating the multi-unit abutments and the bar. Depth is controlled by the markings on the drill; 16 mm is the target for this case.",
   "uncertainty": "I cannot tell whether this is the same drill as in 0077 or already the next one in the protocol. The drill type from the vocabulary (pilot / twist) is not confirmed by either speech or the image. Partially resolved 2026-08-05: the surgeon supplied the drill sequence for this case (Neodent Grand Morse Helix, bone type III–IV, pilot drill to full depth → Ø2.0 mm initial drill to full depth → Ø3.5 mm tapered drill → Ø4.3 mm implant, osteotomy deliberately under-prepared). The narration marks only two drill changes — 'this first drill' at 541.98 s and 'this is a second drill' at 578.56 s — and this frame falls strictly between them, so the instrument in the handpiece is the first of the sequence and is labelled pilot drill at confidence probable (identified_by=drill_protocol_2026-08-05). The label follows the narration window, not the image: the drill body is not readable frame by frame, and no colour-ring-to-diameter table was supplied, so nothing finer can be asserted. Note the tension with L1_phase_detailed above, which reads this frame as the second drill: that was the annotator's own reading of the image, while the 'this is a second drill' line is only spoken at 578.56 s, after this frame. The pilot drill label follows the narration window; L1_phase_detailed is left exactly as the annotator wrote it.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0087",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 675.2,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 668.12,
     "statement": "I'm going to go ahead and put this in.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, brief pause with instruments withdrawn, clear view of the incision line and osteotomy entry points",
   "L2_instruments": [
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "tongue",
    "blood",
    "dental crown (existing restoration)",
    "oral mucosa",
    "lower lip",
    "upper lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal suction tip",
     "aspirate",
     "blood"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retract",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The instruments have been withdrawn from the bone; only the suction tip is in the field — a short pause with inspection of the ridge before the next pass. The line in the window ('put this in') precedes the introduction of the next instrument.",
   "L5_clinical_context": "Clean view of the working field: the incision line along the mandibular ridge, the reflected flap, the osteotomy entry points at the crest, and a preserved crown in the lateral segment. Such a pause with suctioning is usually needed to assess the position and parallelism of the already-formed channels.",
   "uncertainty": "A small metallic element is visible on the left of the ridge — I cannot say whether this is a drill left in the channel, a direction indicator, or a reflection; it is not named in speech. There is no hand in the frame, so gloved hand is not annotated.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0079",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 700.2,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 698.12,
     "statement": "You need three bites on this one. Okay. Mm-hmm.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy, handpiece apparently shifted to the opposite side of the ridge, inferred from the image rather than the speech",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant drill",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "osteotomy site",
    "tongue",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "implant drill",
     "drills into",
     "osteotomy site"
    ],
    [
     "surgical handpiece (contra-angle)",
     "drives drill in",
     "mandibular alveolar ridge"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The speech is unrelated to the action. The handpiece has shifted to the opposite side of the ridge relative to the previous frames — judging by the image, the surgeon has moved to the next site; this is not confirmed by the words.",
   "L5_clinical_context": "Osteotomies are formed sequentially along the arch of the edentulous mandibular ridge; per the case protocol there are five implants in total. A wide retractor holds the flap, exposing the ridge so that adjacent sites can be checked against each other for axis alignment.",
   "uncertainty": "The side and number of the site being prepared are not named in the speech — the conclusion about moving to the next site is drawn from the image alone and is therefore unreliable. The drill type is not distinguishable.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0093",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 800.4,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 824.18,
     "category": "materials",
     "statement": "So this is an implant."
    },
    {
     "time": 827.08,
     "category": "measurement",
     "statement": "4.3 by 13."
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy site prepared, mandibular anterior ridge; gloved fingers hold a small shiny disc-shaped object, plausibly the implant being introduced ahead of the doctor naming and measuring it on camera",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "osteotomy site",
    "gingiva",
    "oral mucosa",
    "blood",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds",
     "dental implant"
    ]
   ],
   "L4_reasoning": "This frame, roughly 24-27 seconds before the doctor names and measures the implant on camera ('So this is an implant.' / '4.3 by 13.'), shows a small shiny object held between gloved fingers that is plausibly the implant fixture on its mount being introduced, consistent with case facts (5 x 4.3x13mm implants) and the ground-truth segment at t=815.",
   "L5_clinical_context": "This is the transition point from osteotomy completion to implant insertion; the first implant is 4.3mm diameter x 13mm length per case facts, to be placed at the 16mm-deep osteotomy site just prepared.",
   "uncertainty": "The small object cannot be confirmed as the implant itself versus its packaging/mount or another small metal component at this resolution; the naming and measurement quotes come from more than 20 seconds after this frame, so the temporal link is inferential, not exact.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0100",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 803.0,
   "phase_index": 3,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 788.12,
     "category": "measurement",
     "statement": "Ok, so everything is prepped to about 16mm and I'm going to put a little antibiotic."
    },
    {
     "time": 805.8,
     "category": "surgical_plan",
     "statement": "And now we're going to put 13mm implant."
    }
   ],
   "L1_phase_normalized": "osteotomy",
   "L1_phase_detailed": "osteotomy completed to depth, mandibular anterior ridge, lateral view; whitish powdery material visible at the ridge alongside an instrument, consistent with the antibiotic powder just mentioned, shortly before the plan to place the 13mm implant",
   "L2_instruments": [
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "antibiotic powder",
     "confidence": "probable",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "osteotomy site",
    "gingiva",
    "blood",
    "oral mucosa",
    "lower lip",
    "upper lip",
    "nose",
    "chin"
   ],
   "L3_triplets": [
    [
     "antibiotic powder",
     "applied to",
     "osteotomy site"
    ]
   ],
   "L4_reasoning": "This frame matches the doctor's statement about applying antibiotic powder after confirming ~16mm osteotomy depth, and immediately precedes the plan to place the 13mm implant; the whitish material visible at the ridge is consistent with antibiotic powder application.",
   "L5_clinical_context": "Routine infection-prevention step (antibiotic powder) before implant insertion; case facts specify 5 x 4.3x13mm implants at 1200rpm drill speed to 16mm depth.",
   "uncertainty": "The whitish substance could be antibiotic powder or bone debris/saliva; not distinguishable with certainty from the image alone. A dark elongated instrument beside it could not be identified with confidence.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0094",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 808.4,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 788.12,
     "category": "measurement",
     "statement": "Ok, so everything is prepped to about 16mm and I'm going to put a little antibiotic."
    },
    {
     "time": 805.8,
     "category": "surgical_plan",
     "statement": "And now we're going to put 13mm implant."
    },
    {
     "time": 824.18,
     "category": "observation",
     "statement": "So this is an implant."
    },
    {
     "time": 827.08,
     "category": "measurement",
     "statement": "4.3 by 13."
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, mandibular ridge prepared and dusted with antibiotic powder immediately before insertion of the first implant",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "antibiotic powder",
     "confidence": "probable",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "osteotomy site",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "chin"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ],
    [
     "plastic suction tubing",
     "evacuates",
     "blood"
    ]
   ],
   "L4_reasoning": "The surgeon has just finished the preparation and announces the transition to placement: \"everything is prepped to about 16mm and I'm going to put a little antibiotic\", then \"And now we're going to put 13mm implant\" and \"So this is an implant. 4.3 by 13.\" The frame shows the prepared field immediately before the first implant is screwed in: no instrument is in the bone yet, the ridge is exposed and dusted with a white powder.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly.",
   "uncertainty": "How much of the site is already prepared and which socket will receive the first implant cannot be determined from the frame. The white coating on the ridge is not visually distinguishable from bone debris; it is attributed to the antibiotic only based on the speech.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0101",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 809.8,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 788.12,
     "statement": "Ok, so everything is prepped to about 16mm and I'm going to put a little antibiotic.",
     "category": "measurement"
    },
    {
     "time": 805.8,
     "statement": "And now we're going to put 13mm implant.",
     "category": "milestone"
    },
    {
     "time": 811.6,
     "statement": "Alright, I'm going to start from here.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "First implant site, immediately after placing antibiotic powder in the prepared osteotomy site, just before inserting the first implant",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "antibiotic powder",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal suction tip",
     "aspirates",
     "blood"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Opening frame of the phase: osteotomy preparation is finished and the surgeon explicitly announces the transition — the sites are ready ‘to about 16mm’, antibiotic has been placed in them, and ‘now we're going to put 13mm implant.’ The white powder on the ridge in the frame is a direct illustration of this statement. The suction tip is positioned in the wound to keep the field dry for implant insertion.",
   "L5_clinical_context": "All-on-4 on the mandible: five implants 4.3x13 mm, osteotomy sites prepared to 16 mm — deeper than the implant length. The ridge is exposed via a mucoperiosteal flap, lips and cheeks retracted with an OptraGate. Implants are placed in the intermental space, anterior to the mental foramina — the key landmark and the main risk for injury to the mental nerve. Local antibiotic in the site is prophylaxis against early infection before the titanium is seated in bone.",
   "uncertainty": "The dark rod entering the mouth from below is identified as a metal suction tip based on the white tubing leading to it, but this is not a strict identification from a single frame. Individual osteotomy sites on the ridge cannot be distinguished — they are covered by the flap edge and powder; how many sites are already prepared cannot be determined from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0109",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 931.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, manual torquing by hand after machine seating with the handpiece",
   "L2_instruments": [
    {
     "name": "torque wrench",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "torque wrench",
     "torques",
     "dental implant"
    ],
    [
     "implant driver",
     "transmits torque to",
     "dental implant"
    ],
    [
     "dental implant",
     "engages",
     "cortical bone"
    ]
   ],
   "L4_reasoning": "The surgeon verbally separates two steps: machine seating with the handpiece is already done, and ‘now we're doing torquing’ means manual tightening follows. The frame shows exactly the manual work: there is no handpiece, a gold-coloured shaft fitted onto the implant head enters the wound from above, and a second driver stands nearby in the ridge.",
   "L5_clinical_context": "Final tightening in the dense cortical bone of the anterior mandible is done manually so the surgeon can feel the resistance and not exceed the torque: excessive torque causes compressive bone necrosis and loss of primary stability, while insufficient torque causes implant mobility, which is unacceptable with immediate loading in All-on-4.",
   "uncertainty": "The tightening instrument is classified as a torque wrench following the surgeon's word ‘torquing’; the frame does not distinguish a manual wrench from an ordinary hand driver — only a gold-coloured shaft without a visible ratchet is in frame. No numeric torque value is readable anywhere, and the implant and its driver are not visually separable.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0114",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 932.4,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "category": "technique",
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing."
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, transition from mechanical seating to manual hand-torquing; torque wrench not visible as hands occlude the field",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "oral mucosa",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "The surgeon directly explains the change of technique: \"we did the mechanical installment on the hand piece and now we're doing torquing\" — the implant has already been seated by the motor, and the manual final tightening follows. In the frame the hands cover the field, the wrench itself is not visible.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly. During final hand-torquing, excessive torque risks compressive bone necrosis and loss of primary stability, so the final tightening is done with a manual torque wrench under resistance control, followed by a reverse turn.",
   "uncertainty": "The torquing instrument is not visible in the frame: the field is completely covered by the hands; only a small gold-coloured element near the finger is distinguishable, and it cannot be attributed to the driver or to the wrench.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0110",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 933.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, continuation of manual torquing, view largely blocked by hands",
   "L2_instruments": [
    {
     "name": "implant driver",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "osteotomy site",
    "cortical bone",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engages",
     "dental implant"
    ]
   ],
   "L4_reasoning": "Continuation of manual torquing: the gold-coloured head of the implant driver stands in the ridge, and the surgeon's hands work over it, blocking the view. The window's speech is the same statement about the transition from machine seating to torquing.",
   "L5_clinical_context": "Manual torquing proceeds with constant monitoring of bone resistance; between passes the instrument is removed from the driver, which is why it appears and disappears across neighbouring frames. The torquing axis must align exactly with the axis of the already-seated implant, otherwise the thread shears in the cortical plate.",
   "uncertainty": "The field is heavily occluded by gloves, and the ridge is visible only in fragments. The small gold-coloured object held in the fingers on the left is not identified (driver, screwdriver, or screw) and is not recorded as a controlled-vocabulary term.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0115",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 938.2,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "category": "technique",
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing."
    },
    {
     "time": 942.32,
     "category": "anatomy",
     "statement": "You can see how it's getting dense."
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, manual torque wrench engaged on the implant driver for final hand-torquing as bone resistance increases",
   "L2_instruments": [
    {
     "name": "torque wrench",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "torque wrench",
     "torques implant into",
     "osteotomy site"
    ],
    [
     "dental implant",
     "engages",
     "cortical bone"
    ],
    [
     "implant driver",
     "transmits torque to",
     "mandibular alveolar ridge"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The frame literally illustrates the speech: \"we did the mechanical installment on the hand piece and now we're doing torquing\" and \"You can see how it's getting dense.\" The head of the manual torque wrench is fitted onto the gold-coloured implant driver — the final tightening is done by hand precisely because the bone's resistance is increasing and the torque needs to be controlled.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly. During final hand-torquing, excessive torque risks compressive bone necrosis and loss of primary stability, so the final tightening is done with a manual torque wrench under resistance control, followed by a reverse turn.",
   "uncertainty": "The instrument is identified as the manual torque wrench; the vocabulary contains both \"torque wrench\" and \"ratchet\" — by shape (a round head with a hole and a straight handle) this is one and the same device, and \"torque wrench\" was chosen following the surgeon's word \"torquing.\" The numeric torque value cannot be read from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0111",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 938.2,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing.",
     "category": "technique"
    },
    {
     "time": 942.32,
     "statement": "You can see how it's getting dense.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, manual torquing with increasing bone resistance ('getting dense') in the symphyseal mandible",
   "L2_instruments": [
    {
     "name": "torque wrench",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "torque wrench",
     "torques",
     "dental implant"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "dental implant",
     "engages",
     "cortical bone"
    ]
   ],
   "L4_reasoning": "The frame illustrates the statement ‘You can see how it's getting dense’: the assistant holds the flap with a gold-coloured retractor, the surgeon manually tightens the implant, and per the speech, bone resistance is increasing. The driver head is visible in the ridge directly under the instrument.",
   "L5_clinical_context": "Increasing density during insertion is a normal finding for the symphyseal zone of the mandible: the bone here is predominantly cortical (D1-D2). This is exactly why the site is prepared to 16 mm for a 13 mm implant — the extra depth reduces the risk of binding at the bottom and overheating during final tightening.",
   "uncertainty": "The manual wrench and the driver cannot be distinguished in the frame; both are recorded based on the word ‘torquing’ in the speech. A second implant/site is not visible from this angle, and the sequence number of the implant being placed cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0116",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 940.6,
   "phase_index": 4,
   "image_quality": "degraded",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "category": "technique",
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing."
    },
    {
     "time": 942.32,
     "category": "anatomy",
     "statement": "You can see how it's getting dense."
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, manual hand-torquing presumably ongoing while the surgeon comments on increasing bone density; field occluded by hands",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "upper lip",
    "oral mucosa"
   ],
   "L3_triplets": [],
   "L4_reasoning": "By speech, manual final tightening of the implant is underway at this moment and the surgeon comments on the increasing bone density, but the frame does not show this: the hands cover the whole field.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly. During final hand-torquing, excessive torque risks compressive bone necrosis and loss of primary stability, so the final tightening is done with a manual torque wrench under resistance control, followed by a reverse turn.",
   "uncertainty": "The frame is blurred and covered by gloves: neither the wrench, the implant, nor the ridge is visible.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0112",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 946.4,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 929.6,
     "statement": "As you see we did the mechanical installment on the hand piece and now we're doing torquing.",
     "category": "technique"
    },
    {
     "time": 942.32,
     "statement": "You can see how it's getting dense.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, manual torquing continues, motion-blurred frame, bone 'getting dense'",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "implant driver",
     "engages",
     "dental implant"
    ]
   ],
   "L4_reasoning": "The same tightening action, frame blurred by motion: a wide gold-coloured retractor blade presses the flap, and below in the wound the gold-coloured head of the implant driver is visible. Per the speech, this is the moment the bone is ‘getting dense.’",
   "L5_clinical_context": "At this moment the retractor performs a dual task: holding the flap and protecting soft tissue from the rotating instrument. Dense bone in the intermental zone requires slow tightening with pauses so as not to overheat the cortical bone or lose primary stability.",
   "uncertainty": "The frame is blurred and instrument details are not readable: a manual wrench cannot be distinguished from a driver, so torque wrench is not recorded here. The bare forearm skin on the right belongs to the assistant and was not annotated.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0113",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 948.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 942.32,
     "statement": "You can see how it's getting dense.",
     "category": "observation"
    },
    {
     "time": 951.58,
     "statement": "Now we're reversing to release the bone a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, reverse half-turn to release compression in dense cortical bone, between torquing passes",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "reverses",
     "dental implant"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "Between the two statements — ‘getting dense’ and ‘reversing to release the bone’ — the surgeon holds a thin gold-coloured shaft on the implant head: this is the moment of reversal, the backward half-turn used to relieve excess stress in the cortical bone.",
   "L5_clinical_context": "A half-turn reversal at high torque is a standard technique: it relieves compression in the cortical plate and reduces the risk of ischemic bone necrosis around the threads, while preserving the primary stability required for immediate loading.",
   "uncertainty": "The direction of rotation cannot be determined from a single frame — the reversal is attributed based on the speech, not the image. The dark metal blade in the lower part of the wound is not identified (second retractor or suction tip).",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0114",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 950.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 942.32,
     "statement": "You can see how it's getting dense.",
     "category": "observation"
    },
    {
     "time": 951.58,
     "statement": "Now we're reversing to release the bone a little bit.",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, reverse step coincides with this frame, field in shadow from a lateral camera angle",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "oral mucosa",
    "blood",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "reverses",
     "dental implant"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The frame coincides in time with the statement about the reversal (delta 0.9 s): the retractor holds the flap, the implant with its driver stands in the site, and the instrument is on it. Lighting has shifted and the field is in shadow — the camera shoots from the side, and the shadow of the surgeon's hands covers the wound.",
   "L5_clinical_context": "After the reversal the implant is usually tightened once more to its final platform position relative to bone. The platform level determines the subsequent height of the multi-unit abutment and the prosthesis emergence profile, so it is monitored visually against the ridge edge.",
   "uncertainty": "The frame is dark, and thread and platform-level details are not readable. The type of hand instrument (wrench or driver) cannot be distinguished; the final position of the implant relative to the ridge cannot be assessed from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0117",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 965.0,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 951.58,
     "category": "technique",
     "statement": "Now we're reversing to release the bone a little bit."
    },
    {
     "time": 958.4,
     "category": "technique",
     "statement": "Now we're going to change retractors and change this side here to this and we're going to"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, reverse-torque release of bone tension followed by a retractor exchange: a new blade is being introduced into the wound while a second retractor already sits on the right",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "antibiotic powder",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "is repositioned in",
     "osteotomy site"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The surgeon has just reversed to release tension in the bone (\"Now we're reversing to release the bone a little bit\") and immediately announces a change of access: \"Now we're going to change retractors and change this side here to this.\" The frame shows exactly this — a new metal blade is being introduced into the wound, with a second one already in place on the right.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly. Changing retractors and switching sides are needed to obtain a straight insertion axis for the next site: when working with the contra-angle handpiece in the anterior region, the access angle is critical for keeping implant axes parallel.",
   "uncertainty": "The wide dark instrument being introduced into the wound is interpreted as a retractor based on the speech about changing retractors; a periosteal elevator cannot be ruled out from a single frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0118",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 968.2,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 958.4,
     "category": "technique",
     "statement": "Now we're going to change retractors and change this side here to this and we're going to"
    },
    {
     "time": 980.96,
     "category": "measurement",
     "statement": "Another implant, same. Implant 4.3 mm, about 13 mm, here, so it stops at 40 mm, right?"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, retractors repositioned, field exposed and prepared in the pause before placement of the next 4.3x13 mm implant",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "antibiotic powder",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "doctor_review_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "keratinized gingiva",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "metal retractor blade",
     "retracts",
     "tongue"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ],
    [
     "metal suction tip",
     "aspirates",
     "blood"
    ]
   ],
   "L4_reasoning": "The retractors have been repositioned (\"Now we're going to change retractors and change this side here to this\"), and right after this frame the surgeon announces the next implant of the same size: \"Another implant, same. Implant 4.3 mm, about 13 mm.\" The frame shows the prepared, exposed field in the pause before the next placement.",
   "L5_clinical_context": "All-on-4 on the mandible: osteotomy sites were prepared to 16 mm for 4.3x13 mm implants, i.e. deeper than the implant length. The ridge is exposed after reflecting the mucoperiosteal flap; the tongue and flap are held by a metal retractor blade, the lips and cheeks by the OptraGate. The key risk zone is the mental foramina and mental nerve: in this protocol implants are placed in the inter-mental segment, anterior to the foramina. The bone in the anterior mandible is dense cortical bone, so insertion torque rises quickly. The frame clearly shows the exposed bone crest with keratinized gingiva along the flap margin — a landmark for judging the implant placement level.",
   "uncertainty": "The quoted line \"so it stops at 40 mm\" was resolved by the surgeon on 2026-08-05: the osteotomy was prepared to 16 mm for a Neodent Grand Morse Helix implant of 4.3 mm diameter and 13 mm length, so the '40' is not a measurement of this site and is not used as a fact anywhere; the L0 quote is kept verbatim as heard. Also closed 2026-08-05: the thin, long, straight metal rod entering the wound from the upper right corner is a surgical stainless steel suction tip — the surgeon identified it from this frame (form question tool_thin_rod). It is now recorded in L2 as metal suction tip (certain, identified_by=doctor_review_2026-08-05), and no unidentified object remains in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0115",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 968.4,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 958.4,
     "statement": "Now we're going to change retractors and change this side here to this and we're going to",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, repositioning retractors to switch access side ahead of the next osteotomy site",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "keratinized gingiva",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "is repositioned in",
     "oral mucosa"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon has just announced the access change (‘we're going to change retractors and change this side here to this’), and the frame shows exactly that: the old blade has been withdrawn, a new one is being inserted into the mouth from the lower left, and the field is fully open at this moment.",
   "L5_clinical_context": "Changing retractors is necessary to obtain a straight insertion axis for the next site: when working in the anterior segment, the access angle determines implant axis parallelism, and a deviation cannot later be compensated for even with angled multi-unit abutments. The open ridge with keratinized gingiva along the flap edge is a landmark for platform level.",
   "uncertainty": "The statement is cut off mid-sentence (‘and we're going to’); the continuation did not make it into the batch, so what is planned next cannot be reconstructed from the text. The heads of the already-placed implants are not visible from this angle, and the number already placed cannot be verified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0119",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 970.2,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 958.4,
     "statement": "Now we're going to change retractors and change this side here to this and we're going to",
     "category": "technique"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Field held open by finger between retractor exchange and next implant, anterior mandibular crest",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts the flap and the soft tissue away from the crest",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The retractors have been removed, the field is being held open by a finger - an intermediate moment during the instrument exchange the surgeon talks about at 15:46. The crest is exposed and wet with blood, bleeding is moderate, no separate hemostasis is being performed.",
   "L5_clinical_context": "The upper teeth with a metal restoration appear at the top of the frame - a midline landmark for assessing the position of the mandibular crest. The open flap in the anterior mandible is bleeding heavily from cancellous bone; the blood must be cleared, otherwise the osteotomy openings are not visible and the implant insertion direction would be set blindly.",
   "uncertainty": "A white plastic object to the right of the crest cannot be identified from the frame (lingual retractor, suction tip, or a part of the lip retractor) - not entered in L2_other. Implants already placed by this point are not visible: the crest is covered by the finger and blood.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0116",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 974.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": 3,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 958.4,
     "statement": "Now we're going to change retractors and change this side here to this and we're going to",
     "category": "surgical_plan"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, retractor swap in progress: new blade being inserted on one side while the other retractor still holds the flap",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "metal suction tip",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "keratinized gingiva",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "is repositioned in",
     "oral mucosa"
    ],
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "A direct illustration of the same statement: on the right the surgeon inserts a new long dark blade into the mouth, on the left the assistant's gold-coloured retractor continues to hold the flap, and the suction tip remains in the wound below. Access is being rebuilt before the next site.",
   "L5_clinical_context": "When repositioning the retractor, the blade is guided subperiosteally along the bone so as not to tear the flap or injure the neurovascular bundle at the mental foramen. At this moment the wound is necessarily kept dry: fresh blood obscures the bone edge and hinders assessment of platform level.",
   "uncertainty": "Which specific retractor is being inserted (buccal or lingual) cannot be determined from the frame — only the blade is visible. The dark spots on the ridge could be either the openings of osteotomy sites or the heads of already-placed implants; they cannot be distinguished.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0117",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 976.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 958.4,
     "statement": "Now we're going to change retractors and change this side here to this and we're going to",
     "category": "surgical_plan"
    },
    {
     "time": 980.96,
     "statement": "Another implant, same. Implant 4.3 mm, about 13 mm, here, so it stops at 40 mm, right?",
     "category": "measurement"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Implant placement, ridge re-exposed and dried after retractor swap, immediately before seating the next 4.3x13 mm implant",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "antibiotic powder",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "keratinized gingiva",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds open",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The retractors have been repositioned, the field is open and dried — and at exactly this moment the surgeon announces the next implant of the same size. The frame captures the prepared ridge with the site openings immediately before the next seating.",
   "L5_clinical_context": "Before inserting the next implant the site is inspected: it matters that the bone edge is even after alveoloplasty, and the sites lie in the intermental space, anterior to the mental foramina. A 16 mm site for a 13 mm implant provides a margin so the implant does not hit the bottom or bind.",
   "uncertainty": "The quoted statement ‘so it stops at 40 mm’ was resolved by the surgeon on 2026-08-05: the osteotomy was prepared to 16 mm for a Neodent Grand Morse Helix implant of 4.3 mm diameter and 13 mm length, so the '40' is not a measurement of this site and is not used as a fact anywhere; the L0 quote is kept verbatim as heard. The thin metal shaft entering the wound from below is not identified. Exactly how many sites are visible on the ridge cannot be counted from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0139",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1136.6,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1114.7,
     "statement": "All right.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "Final implant site of the phase: handpiece with drill on crest along planned axis, ~38 s before 'all implants installed' milestone",
   "L2_instruments": [
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant drill",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "osteotomy site",
    "mucoperiosteal flap",
    "cortical bone",
    "blood",
    "oral mucosa",
    "lower lip",
    "maxillary teeth"
   ],
   "L3_triplets": [
    [
     "surgical handpiece (contra-angle)",
     "works on the crest along the planned implant axis",
     "osteotomy site"
    ],
    [
     "implant drill",
     "penetrates the crestal bone",
     "mandibular alveolar ridge"
    ],
    [
     "metal retractor blade",
     "retracts the lower lip and protects the soft tissue",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The last position in this phase: the handpiece is lowered onto the crest, a long thin shaft goes into the bone along the axis of the future implant. About 38 seconds later the surgeon marks the milestone 'all implants are installed' and moves on to the multi-unit abutments, meaning that the preparation and seating of the last implant is being completed here.",
   "L5_clinical_context": "Per the case protocol, the osteotomy site is prepared to 16 mm for a 13 mm implant at 1200 rpm with irrigation. The axis is kept within the interforaminal zone; apically the landmark is the lower border of the mandible, and buccolingually it is the thickness of the cortical plates - perforation of the lingual wall risks bleeding into the floor of the mouth.",
   "uncertainty": "The type of bur cannot be distinguished from the frame - a generic implant drill is used per the case's unified decision. Drilling and machine-driven implant seating cannot be distinguished from the still frame: the implant body under the handpiece head is not visible; only a long thin shaft is in the field. The nearby speech ('All right') provides no content.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0133",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1166.0,
   "phase_index": 4,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1174.7,
     "statement": "It is closed, so we are going to put a multi unit abutment so all implants are installed",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "implant_placement",
   "L1_phase_detailed": "implant placement, final overview of the ridge crest with the instrument withdrawn, immediately before the 'all implants installed' milestone statement",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical handpiece (contra-angle)",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "dental implant",
     "confidence": "probable",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "cortical bone",
    "osteotomy site",
    "gingiva",
    "lower lip",
    "oral mucosa",
    "blood",
    "nose"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the flap and exposes the full length of",
     "mandibular alveolar ridge"
    ],
    [
     "surgical handpiece (contra-angle)",
     "is lifted away from",
     "osteotomy site"
    ]
   ],
   "L4_reasoning": "Final frame of the batch: the ridge is fully exposed, the instrument is withdrawn from the bone, and a row of implant shaft openings with metallic glints is visible on the crest. 8 s later the surgeon states the milestone — \"It is closed, so we are going to put a multi unit abutment so all implants are installed\" — meaning implant placement is complete and the next stage is the multi-unit abutments. The frame shows precisely a check-up overview before the change of stage.",
   "L5_clinical_context": "Outcome of the All-on-X stage on the mandible: 4.3×13 mm implants are distributed along an arc between the mental foramina, the flap is still reflected. Next come the multi-unit abutments tightened to 25 N·cm, soft-tissue profile correction, and suturing. The check points on this frame are the level of the platforms relative to the ridge and the absence of active bleeding.",
   "uncertainty": "The quote in L0 was spoken at 1162.7 s, i.e. 8.7 s after the frame — it describes an already-completed state, not the moment of the frame. The exact number of implants placed cannot be counted from the frame: part of the shafts are in the shadow of the retractor and behind the edge of the lip, and an implant shaft cannot be distinguished from an empty osteotomy. The instrument above is identified as the angled handpiece by the shape of its head; it does not fully appear in the frame. The segment at 1178.3 s about \"chopped green chillies\" is an obvious transcription hallucination and was not used.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0149",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1177.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1174.7,
     "statement": "It is closed, so we are going to put a multi unit abutment so all implants are installed.",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multiunit abutment stage begins; inspecting the closed anterior ridge before seating abutments, right side partly obscured",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "tongue",
    "lower lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "blood",
    "chin"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "retracts the cheek and flap on the right side to expose the mandibular ridge",
     "mandibular alveolar ridge"
    ],
    [
     "plastic suction tubing",
     "evacuates blood and saliva from the floor of the mouth",
     "blood"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "holds lips and cheeks away from the operative field",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The surgeon has just announced that the flap is closed and all implants are placed — the implant-placement stage is complete and the prosthetic stage begins: inspecting the ridge before placing the multi-unit abutments. The field is first dried and opened up to expose the implant heads.",
   "L5_clinical_context": "Mandible, edentulous anterior ridge segment with the mucoperiosteal flap laid down; posteriorly the patient's own teeth with metal crowns are preserved. The main anatomical risk in this area is the mental foramina and the nerve emerging from them near the premolars, so retraction and manipulation are performed carefully, without heavy pressure on the buccal side.",
   "uncertainty": "No implant head or abutment is visible in the frame — the mucosa lies over them; how many implants there are and exactly where they are positioned cannot be established from this frame. The right side of the field is occluded by the retractor and a hand.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0134",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1183.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1174.7,
     "category": "milestone",
     "statement": "It is closed, so we are going to put a multi unit abutment so all implants are installed."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Mandible, first multi-unit abutment being connected onto an implant immediately after the surgeon confirms the flap is closed and all five implants are installed; OptraGate retractor and suction in place.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal suction tip",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "oral mucosa",
    "lower lip",
    "upper lip",
    "chin",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "multi-unit abutment",
     "sits in",
     "mandibular alveolar ridge"
    ],
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "Coming right after the milestone statement that all implants are installed and the flap is closed, this frame shows the first multi-unit abutment already engaged on its mandibular implant; the surgeon is beginning the sequential abutment-connection step that follows implant placement.",
   "L5_clinical_context": "A single gold-toned, titanium-nitride-coated multi-unit abutment (Nobel Biocare) projects from the mandibular ridge; the maxillary antagonist dentition, including a gold crown and a metal crown, is visible at the posterior corner of the retractor opening and will serve as the occlusal/rotational reference (central fossa) for this and the remaining abutments. Final abutment torque for this case is 25 Ncm per case facts, applied later in the phase, not in this frame.",
   "uncertainty": "Which of the five implant sites this abutment corresponds to cannot be determined from the frame; whether the abutment is only finger-seated or already fully engaged cannot be confirmed visually.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0188",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1284.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "surgeon working at the left-side abutment while the assistant suctions the right-side abutment",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "working at the left abutment site",
     "multi-unit abutment"
    ],
    [
     "plastic suction tubing",
     "draining blood at the right abutment",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "The field partially opens up: on the left the surgeon works at the abutment, on the right the assistant holds the suction. This is the middle of the 'seat -- check -- tighten' sequence, which will end with torquing to 25 Ncm.",
   "L5_clinical_context": "The mandibular ridge is bloodied, the tongue is pressed against the floor of the mouth. The abutments stand distally on both sides -- these are the positions of the tilted All-on-4 implants.",
   "uncertainty": "The instrument in the left hand is hidden by the glove and the shadow, it cannot be identified. There is no speech nearby: the nearest segment is flagged.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0162",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1285.0,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; gloved hand holds a thin metallic-tipped instrument with a dark handle and brings it toward the ridge, gold abutment visible at the right edge of the field",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "manipulates",
     "gingiva"
    ]
   ],
   "L4_reasoning": "The instrument is being positioned at the ridge, likely to hold tissue clear of the multi-unit abutment so its seating can be checked or continued.",
   "L5_clinical_context": "Mandibular multi-unit abutment site with active tissue management.",
   "uncertainty": "Exact instrument identity (elevator vs. probe) not confirmable from this angle; maxillary crown not clearly resolvable in this specific frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0189",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1287.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "retracting the tongue off the mandibular ridge to expose the anterior abutment sites",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "sliding under the tongue to lift it off the mandibular ridge",
     "tongue"
    ]
   ],
   "L4_reasoning": "A flat metal retractor is introduced into the field and used to retract the tongue: without this, the anterior part of the ridge, where the remaining multi-unit abutments sit, is hidden both from the overhead camera and from the surgeon himself. This is preparation for driver work in the anterior segment.",
   "L5_clinical_context": "The tongue of the sedated patient is relaxed and keeps sliding onto the ridge; it is retracted lingually with the blade, while at the same time protecting the floor of the mouth from the instrument. Pressure from the blade must be measured -- the sublingual vessels run under the mucosa of the floor of the mouth.",
   "uncertainty": "The blade is dark and strongly reflective, no perforations are visible on it -- it could also be a fenestrated tongue retractor; the more general term from the vocabulary was chosen. The left abutment is covered by the glove.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0163",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1287.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; two gloved hands in frame, one holding a longer thin instrument pointed toward the center of the ridge near the abutment, small maxillary crown sliver visible at bottom left near the suction tube",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "retracts",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Two-handed instrument work at the ridge is consistent with continued multi-unit abutment handling, with the second hand likely providing retraction or stabilization.",
   "L5_clinical_context": "Mandibular multi-unit abutment site; small maxillary crown sliver at the periphery is the antagonist arch, not to be read as a second mandibular abutment.",
   "uncertainty": "The thin instrument's precise identity is not certain from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0190",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1289.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "tongue retracted exposing the right-side multi-unit abutment and adjacent gingiva for driver access",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "holding the tongue medially away from the right abutment",
     "tongue"
    ],
    [
     "multi-unit abutment",
     "exposed on the ridge once the tongue is retracted",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The retractor is already in place: the tongue is retracted, and the right multi-unit with the adjacent gingiva becomes fully visible. This is exactly the access needed to fit the driver onto the abutment's hex without pinching the mucosa in the process.",
   "L5_clinical_context": "Retracting the tongue opens up the lingual surface of the ridge -- the zone where unremoved tissue most often remains and where the abutment can press against the mucosa. On the left, the second abutment is visible, the ridge between them is covered by the flap.",
   "uncertainty": "The retractor type cannot be unambiguously determined from the reflective blade. What the hand on the left is doing is not visible, it is outside the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0191",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1291.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "simultaneous tongue and lip retraction opening the anterior ridge corridor before driver insertion",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "keeping the tongue retracted during the abutment work",
     "tongue"
    ],
    [
     "gloved hand",
     "pulling the lower lip down to widen the frontal access",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Two retractions at the same time -- the tongue with the blade, the lip with the hand: this is how a corridor to the anterior part of the ridge is formed. In the next step the driver enters the frame, meaning this is direct preparation for seating the next multi-unit.",
   "L5_clinical_context": "The working zone is the mandibular ridge between the mental foramina. Simultaneous traction on the lip and the tongue increases visibility but stretches the incision edges, so bleeding along the flap line increases.",
   "uncertainty": "The abutments are only partially visible (the left one is covered by the glove). There is no speech nearby -- the nearest segments are flagged, the phase link is contextual.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0164",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1292.8,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; the field is mostly occluded by a gloved hand holding an instrument near the top of the frame, only a tiny gold sliver remains visible at bottom right",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa"
   ],
   "L3_triplets": [],
   "L4_reasoning": "Cannot be determined precisely; the hand and instrument dominate the frame, consistent with active manipulation at the site continuing from the previous frames.",
   "L5_clinical_context": "Presumed continuation of mandibular multi-unit abutment work; visual confirmation limited.",
   "uncertainty": "Most of the surgical field is blocked by the surgeon's hand; the small gold sliver at bottom right is presumed to be the multi-unit abutment seen consistently in this sequence but cannot be confirmed in isolation.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0192",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1296.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "implant driver engaging the screw of the left-side multi-unit abutment, seating onto the implant platform",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "gingiva",
    "oral mucosa",
    "blood",
    "mucoperiosteal flap",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engaging the screw of the multi-unit abutment on the left implant",
     "multi-unit abutment"
    ],
    [
     "plastic suction tubing",
     "suctioning beside the contralateral abutment",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "A key frame of this segment: the driver shaft is inserted into the left multi-unit, and the abutment is being screwed onto the implant. The abutment is first hand-tightened, checking that it has seated onto the platform without pinching the gingiva, and only then is the final torque of 25 Ncm applied. Confirmed by the paired frame sony_lateral_0165, where the same gold-colored driver is visible from the side.",
   "L5_clinical_context": "The multi-unit with the gold-colored titanium-nitride coating (Nobel Biocare) sits on the distal mandibular implant; around it is the gingival cuff and the edge of the elevated flap. The main risks at this step are pinching the mucosa between the abutment and the implant platform, and missing the hex, stripping the screw.",
   "uncertainty": "The junction between the abutment and the implant is hidden by the gingiva, so full seating cannot be judged from the frame. The light-colored element to the right of the abutment (possibly a plastic carrier or a cap) is not classified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0165",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1296.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge, clear lateral view; gloved fingers hold back the upper lip/cheek tissue, the tongue occupies the center of the field, a gold multi-unit abutment (hex-drive stub) is clearly visible mid-right on the ridge with a small maxillary crown sliver visible at bottom left near the suction tube",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ],
    [
     "plastic suction tubing",
     "drains",
     "blood"
    ]
   ],
   "L4_reasoning": "This is the clearest view in the sequence of the seated multi-unit abutment on the mandibular ridge, consistent with the phase's central activity of connecting abutments to the implants placed earlier in the case.",
   "L5_clinical_context": "Mandible, multi-unit abutment (titanium-nitride, gold-colored) seated on the ridge; the maxillary crown sliver at the periphery belongs to the patient's own dentition and is a separate, pre-existing restoration, cross-checked against the paired lumix_overhead frame at the same timestamp which shows both the gold and metal maxillary crowns clearly.",
   "uncertainty": "None significant for this frame; the abutment identification is well supported both visually and by cross-referencing the paired overhead camera.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0193",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1298.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "hand-tightening the left-side multi-unit abutment with the driver held vertically, before torque wrench",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "gingiva",
    "oral mucosa",
    "blood",
    "mucoperiosteal flap",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "turning the multi-unit abutment down onto the implant platform",
     "multi-unit abutment"
    ],
    [
     "gloved hand",
     "retracting the lower lip during the screwing",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Continuation of the screwing: the driver stands vertically in the abutment, the surgeon is hand-tightening it. Hand-tightening is mandatory in order to feel the conical seating before applying the torque wrench.",
   "L5_clinical_context": "The axis of the driver is clearly visible -- it sets the direction of the screw channel; it is exactly this axis that the surgeon relates to the central fossa of the antagonist. The second abutment on the right remains under the suction, the ridge between them is covered by the flap and the tongue.",
   "uncertainty": "The amount of tightening cannot be determined from the frame, there is no torque wrench in the frame. The whitish area next to the left abutment (bone or a plastic element) is not identified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0166",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1298.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; gloved hand continues to hold back the upper lip/cheek tissue, gold multi-unit abutment visible mid-right, small maxillary crown sliver at bottom left near the suction tube base",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "Continuation of the previous frame; the abutment remains seated and visible while the tissue is held clear for inspection.",
   "L5_clinical_context": "Same mandibular multi-unit abutment site as the prior frame; maxillary crown sliver is the antagonist arch.",
   "uncertainty": "None significant.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0167",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1300.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; gloved hand pinches/holds the cheek and upper lip tissue, gold multi-unit abutment visible mid-right partially obscured by the retracting hand, small crown sliver bottom left",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "Continued tissue retraction around the multi-unit abutment site.",
   "L5_clinical_context": "Mandibular multi-unit abutment site, partially obscured by the retracting hand in this frame.",
   "uncertainty": "The abutment is partly covered by the gloved fingers, reducing confidence slightly compared to frames 0165/0166.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0194",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1302.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "implant driver lifted off an abutment and held over the anterior ridge, between positions",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "lifted off the abutment and held over the anterior ridge",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The driver has been lifted off the abutment and is held over the anterior part of the ridge -- either the abutment has been fully tightened, or the instrument is being moved to the next position. Between positions the surgeon re-evaluates the exit of the screw channel each time.",
   "L5_clinical_context": "Both distal multi-unit abutments stand on either side of the tongue, the anterior part of the ridge is open. A small instrument over the open oral cavity of a sedated patient is always held braced on a finger -- there is a risk of a component falling into the throat.",
   "uncertainty": "It is not visible whether there is an abutment or a cap on the tip of the driver. Exactly which of the anterior positions the driver is directed toward cannot be determined from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0168",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1302.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; a large gloved fist occupies most of the frame, only a small gold sliver at bottom right and a faint crown sliver at bottom left remain visible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa"
   ],
   "L3_triplets": [],
   "L4_reasoning": "Cannot be determined precisely due to heavy hand obstruction; presumed continuation of tissue/abutment handling.",
   "L5_clinical_context": "Presumed continuation of the mandibular multi-unit abutment site work.",
   "uncertainty": "The surgeon's hand occupies almost the entire frame; only slivers of the abutment and crown are visible at the margins, insufficient for a confident, detailed reading of this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0195",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1304.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "checking seated posterior abutments and surrounding gingival cuff before gingival profiling and final torque",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "gingiva",
    "oral mucosa",
    "blood",
    "mucoperiosteal flap",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "multi-unit abutment",
     "seated on the implants at both posterior positions",
     "mandibular alveolar ridge"
    ],
    [
     "plastic suction tubing",
     "clearing the field around the right abutment",
     "gingiva"
    ]
   ],
   "L4_reasoning": "Instruments are withdrawn, the field is open: a check-look at the seated abutments and the gingival cuff around them. This check is needed before the next step -- gingival profiling and final torquing.",
   "L5_clinical_context": "The incision line along the ridge with dried blood is visible, along with the soft tissue around the abutments. If the gingiva encroaches onto the multi-unit platform, it is profiled with a bur on reverse rotation -- the surgeon mentions this later in the phase.",
   "uncertainty": "The anterior implant positions are covered by the tongue and the lip, so all five abutments cannot be judged from the frame. There is no non-flagged speech nearby.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0196",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1306.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "statement": "So, let's go.",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "implant driver entering the anterior mandibular ridge for the next multi-unit abutment, tongue retracted",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "placed onto an abutment screw at the anterior mandible",
     "multi-unit abutment"
    ],
    [
     "metal retractor blade",
     "retracting the tongue on the opposite side during the work",
     "tongue"
    ]
   ],
   "L4_reasoning": "The surgeon brings the gold-tipped instrument into the anterior part of the ridge, while the assistant simultaneously keeps the tongue retracted -- work on the next multi-unit begins. The line 'So, let's go.' coincides in time with the start of this approach.",
   "L5_clinical_context": "The anterior implants in All-on-4 stand vertically between the mental foramina, access to them from under the lower lip is the narrowest, so both the tongue retractor and manual lip retraction are needed. The work is in the zone of dense cortical bone.",
   "uncertainty": "The gray cylindrical body of the instrument could be either the handle of a hand driver or the tip -- this cannot be distinguished from the frame; only the confidently visible working shaft was entered in L2 as implant driver. The line is short and non-technical, and gives no substantive link to the action.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0197",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1315.0,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "statement": "So, let's go.",
     "category": "milestone"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "seating/hand-tightening the anterior mandibular multi-unit abutment with the driver held vertically",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "oral mucosa",
    "blood",
    "mucoperiosteal flap",
    "mandibular alveolar ridge"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "standing vertically in an abutment at the anterior mandibular ridge",
     "multi-unit abutment"
    ],
    [
     "metal retractor blade",
     "holding the tongue away from the anterior working area",
     "tongue"
    ]
   ],
   "L4_reasoning": "The instrument stands vertically in the anterior part of the ridge -- this is the seating/tightening of the next multi-unit on the anterior implant. By this point the distal abutments are already in place, the work proceeds along the arch toward the center, after which the torquing of all the multi-unit abutments to 25 Ncm will follow.",
   "L5_clinical_context": "The anterior segment of the mandible between the mental foramina: here the implants stand vertically and the mucosa is thin and mobile, so the tongue is always retracted with the blade. The incision line along the ridge with blood is visible.",
   "uncertainty": "The frame is dark, the hand at the top is blurred. A thin curved thread/loop is visible on the gold-colored component -- possibly a safety tether on the driver, but it cannot be confidently identified and is not entered in the annotation. The abutment itself cannot be distinguished from the driver fitted onto it at this exposure.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0169",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1315.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "category": "milestone",
     "statement": "So, let's go."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "transition at the mandibular multi-unit abutment site; camera view is dominated by the retractor rim, gauze and drape, with only a narrow sliver of pink tissue visible at the top of the oval; a purple-gloved hand holds a thin, dark, pointed instrument at the left edge",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa",
    "upper lip",
    "lower lip"
   ],
   "L3_triplets": [],
   "L4_reasoning": "The surgeon's remark ('So, let's go.') marks a transition to a new step; the reduced view and instrument approaching from the corner of the mouth suggest an instrument exchange before the next part of the abutment procedure.",
   "L5_clinical_context": "Mandibular multi-unit abutment phase, mouth mostly closed/retracted at this moment, limiting visibility of the implant site itself.",
   "uncertainty": "The mouth opening is very narrow in this frame; the ridge and abutment are not visible, and the instrument at the left edge cannot be identified with certainty.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0198",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1317.0,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "statement": "So, let's go.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Handpiece withdrawn; brief pause between abutment placements, field held open and dried.",
   "L2_instruments": [
    {
     "name": "metal retractor blade",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "saliva",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "metal retractor blade",
     "holds the tongue away from the mandibular ridge",
     "tongue"
    ],
    [
     "plastic suction tubing",
     "evacuates blood from the floor of the mouth",
     "blood"
    ]
   ],
   "L4_reasoning": "The handpiece has been withdrawn from the mouth; only retraction and suction remain in the field - a short pause between abutment placements, the field is held open and dried.",
   "L5_clinical_context": "Overhead view: the mandibular ridge lies beneath the tongue and the floor of the mouth, so it is barely visible without tongue retraction. The maxilla is partially edentulous: single crowns remain (a gold one on the left of frame, the patient's right side, and metal ones on the right of frame). These antagonist teeth provide the landmark the surgeon refers to at 20:18 (\"central fossa\"): the abutment axis and screw-channel exit should land in the central fossa of the opposing tooth. The working zone is the anterior mandible between the mental foramina; lateral to the premolars any manipulation risks the mental nerve.",
   "uncertainty": "A second, thin, curved metal instrument is visible in the center of the frame; it cannot be identified from the image (a metal suction tip, an elevator, or a retractor blade), so it was not entered in L2. No abutments are visible on the ridge - the ridge is covered by the tongue and the blade.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0170",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1317.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "category": "milestone",
     "statement": "So, let's go."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "transition at the mandibular multi-unit abutment site; two gloved hands (purple and blue) visible, one holding a thin dark instrument approaching the retractor from the left, mouth opening still narrow",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "oral mucosa",
    "upper lip",
    "lower lip"
   ],
   "L3_triplets": [],
   "L4_reasoning": "Continuation of the instrument approach seen in the previous frame; two sets of gloved hands suggest the surgeon and an assistant are both engaged at the retractor.",
   "L5_clinical_context": "Mandibular multi-unit abutment phase; ridge and abutment not directly visible in this frame.",
   "uncertainty": "Instrument identity remains uncertain; the two glove colors likely indicate surgeon and assistant hands, not otherwise distinguishable in the controlled vocabulary.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0199",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1319.0,
   "phase_index": 5,
   "image_quality": "degraded",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "",
   "L2_instruments": [],
   "L2_other": [],
   "anatomy_visible": [],
   "L3_triplets": [],
   "L4_reasoning": "",
   "L5_clinical_context": "",
   "uncertainty": "The frame is degraded: almost the entire field is covered by a blue glove; only the lips, the retractor ring, the nasal cannula, and a narrow dark mouth opening with a metal crown are visible. There is no surgical field (ridge, abutments, instrument in the wound) in the frame, so it was annotated minimally. The nearest non-flagged line, \"So, let's go.\", occurs 8.7 s before the frame and is not attributed to it.",
   "no_surgical_field": true
  },
  {
   "keyframe_id": "sony_lateral_0171",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1319.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "category": "milestone",
     "statement": "So, let's go."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; mouth opening widens again, a thin dark pointed instrument is inserted toward the site from the left, gold abutment component becomes visible again at bottom right edge",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "oral mucosa",
    "upper lip",
    "lower lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "approaches",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The instrument is being brought back toward the abutment site as the field reopens, resuming the work interrupted during the narrower-view frames.",
   "L5_clinical_context": "Mandibular multi-unit abutment site becoming visible again after the brief instrument-exchange transition.",
   "uncertainty": "Instrument identity still not fully certain; abutment only partially visible at the frame edge.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0200",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1321.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "statement": "So, let's go.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Working at the implant site under the patient's right posterior mandibular ridge, near the upper gold crown antagonist; hand largely obscures the field.",
   "L2_instruments": [
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "works at the implant site under the patient's right posterior region",
     "mandibular alveolar ridge"
    ],
    [
     "plastic suction tubing",
     "evacuates blood near the ridge",
     "blood"
    ]
   ],
   "L4_reasoning": "The surgeon's hand covers more than half of the frame, but at the ridge on the patient's right side (left of frame, under the gold crown antagonist) a gold-toned metal element is visible - the same instrument/component as in the next frame: work is under way on the abutment at this position.",
   "L5_clinical_context": "Overhead view: the mandibular ridge lies beneath the tongue and the floor of the mouth, so it is barely visible without tongue retraction. The maxilla is partially edentulous: single crowns remain (a gold one on the left of frame, the patient's right side, and metal ones on the right of frame). These antagonist teeth provide the landmark the surgeon refers to at 20:18 (\"central fossa\"): the abutment axis and screw-channel exit should land in the central fossa of the opposing tooth. The working zone is the anterior mandible between the mental foramina; lateral to the premolars any manipulation risks the mental nerve.",
   "uncertainty": "Only the tip of the gold-toned element is visible at the ridge; the driver cannot be told apart from an abutment mounted on it. Most of the field is covered by the glove, so the state of the remaining positions cannot be assessed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0172",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1322.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge, clear view restored; gloved hand holds back the upper lip/cheek tissue, gold multi-unit abutment clearly visible mid-right, small maxillary crown sliver bottom left near the suction tube",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "The view has returned to a clear presentation of the seated multi-unit abutment, matching the earlier clear frames (0165/0166) of the same site.",
   "L5_clinical_context": "Mandibular multi-unit abutment site; maxillary crown sliver is the antagonist arch, not a second mandibular abutment.",
   "uncertainty": "None significant for this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0201",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1323.6,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1310.3,
     "statement": "So, let's go.",
     "category": "observation"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Checking seating/axis of the multi-unit abutment at the patient's right anterior mandibular ridge against the opposing gold crown, per the surgeon's 'central fossa' remark.",
   "L2_instruments": [
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "saliva",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engages the abutment/implant at the patient's right side of the mandibular ridge",
     "mandibular alveolar ridge"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "keeps the lips and cheeks retracted",
     "lower lip"
    ],
    [
     "plastic suction tubing",
     "evacuates blood and saliva",
     "blood"
    ]
   ],
   "L4_reasoning": "The working position is clearly visible: a gold-toned rod stands in the ridge on the patient's right side and its upper part rests against the area of the gold crown antagonist. This is the check/seating of the multi-unit abutment with an assessment of its axis relative to the opposing tooth - what the surgeon referred to at 20:18 (\"when we replace this abutment it goes into the central fossa\").",
   "L5_clinical_context": "Overhead view: the mandibular ridge lies beneath the tongue and the floor of the mouth, so it is barely visible without tongue retraction. The maxilla is partially edentulous: single crowns remain (a gold one on the left of frame, the patient's right side, and metal ones on the right of frame). These antagonist teeth provide the landmark the surgeon refers to at 20:18 (\"central fossa\"): the abutment axis and screw-channel exit should land in the central fossa of the opposing tooth. The working zone is the anterior mandible between the mental foramina; lateral to the premolars any manipulation risks the mental nerve. The abutment's angulation is chosen so that the screw shaft exits into the central fossa rather than into the buccal or lingual surface of the future prosthesis; otherwise the prosthesis would have to be relieved with a hole in an inconvenient spot.",
   "uncertainty": "The frame does not allow separating what exactly stands in the ridge: the multi-unit abutment itself, a hand driver in its shaft, or a carrier with the abutment. The implant number and the abutment angle cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0173",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1325.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment site, mandibular ridge; two gloved hands present, gold multi-unit abutment visible mid-right, small maxillary crown sliver bottom left, thin instrument tip visible pointed toward the ridge",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "oral mucosa",
    "blood",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "retracts",
     "gingiva"
    ]
   ],
   "L4_reasoning": "Continued instrument work at the multi-unit abutment site, likely checking or adjusting the surrounding soft tissue.",
   "L5_clinical_context": "Mandibular multi-unit abutment site with maxillary crown sliver visible as antagonist arch.",
   "uncertainty": "Exact instrument identity uncertain.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0202",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1326.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Intermediate frame between two abutment approaches; instrument withdrawn, mandibular ridge hidden under tongue and glove.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "gingiva",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "saliva",
    "upper lip",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "holds the lips and cheeks open",
     "upper lip"
    ],
    [
     "plastic suction tubing",
     "evacuates saliva at the patient's left",
     "saliva"
    ]
   ],
   "L4_reasoning": "The instrument has been withdrawn from the wound, the surgeon's hand covers the left half of the frame; the open oral cavity is visible with the tongue and the antagonist crowns. An intermediate frame between two approaches to the abutments.",
   "L5_clinical_context": "Overhead view: the mandibular ridge lies beneath the tongue and the floor of the mouth, so it is barely visible without tongue retraction. The maxilla is partially edentulous: single crowns remain (a gold one on the left of frame, the patient's right side, and metal ones on the right of frame). These antagonist teeth provide the landmark the surgeon refers to at 20:18 (\"central fossa\"): the abutment axis and screw-channel exit should land in the central fossa of the opposing tooth. The working zone is the anterior mandible between the mental foramina; lateral to the premolars any manipulation risks the mental nerve.",
   "uncertainty": "The mandibular ridge is covered by the glove and the tongue - neither abutments nor implants are visible. The nearest non-flagged line (\"So, let's go.\") is almost 16 s away, so it was not entered in L0.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0203",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1328.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": 4,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Open overview frame, no instrument in the wound; anterior edentulous maxilla with flanking crowns visible, ahead of the try-in of the removable denture.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "oral mucosa",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "saliva",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts the lips and cheeks",
     "lower lip"
    ],
    [
     "plastic suction tubing",
     "evacuates blood and saliva from the field",
     "saliva"
    ]
   ],
   "L4_reasoning": "A free overview frame with no instruments in the wound: the field is open, showing the anterior edentulous maxillary area with single crowns at the margins - it is this area onto which the removable denture will be seated shortly to check the relationship with the abutments.",
   "L5_clinical_context": "Overhead view: the mandibular ridge lies beneath the tongue and the floor of the mouth, so it is barely visible without tongue retraction. The maxilla is partially edentulous: single crowns remain (a gold one on the left of frame, the patient's right side, and metal ones on the right of frame). These antagonist teeth provide the landmark the surgeon refers to at 20:18 (\"central fossa\"): the abutment axis and screw-channel exit should land in the central fossa of the opposing tooth. The working zone is the anterior mandible between the mental foramina; lateral to the premolars any manipulation risks the mental nerve. It is clearly visible that the anterior maxilla is edentulous and the remaining teeth are only the posterior ones under crowns; this limits the number of available antagonist landmarks.",
   "uncertainty": "No abutments are visible in the frame: the mandibular ridge is covered by the tongue and the floor of the mouth. There is no speech within +/-15 s, so L0 is empty.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0192",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1414.4,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1400.3,
     "category": "technique",
     "statement": "Close, look right there, that's how, teeth are right there so we're gonna do, open, and"
    },
    {
     "time": 1418.82,
     "category": "measurement",
     "statement": "the bone is back so we're gonna do, okay, so all gonna be this, 3/5's."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "mandibular arch, wide view during the bone-level remark, verification piece still near the ridge against the antagonist arch",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "trial denture (try-in)",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds",
     "trial denture"
    ]
   ],
   "L4_reasoning": "The 'bone is back' comment, together with the verification piece being held against the antagonist arch, suggests the surgeon is relating bone/tissue level to how much abutment height or profiling is needed.",
   "L5_clinical_context": "The '3/5's' figure that follows is flagged in case_facts as a pending, unresolved transcription (possibly '3.5'); it is quoted here verbatim as instructed but not treated as a confirmed measurement.",
   "uncertainty": "The '3/5's' remark is an unresolved transcription per case_facts (status: pending_doctor, possible reading '3.5'); recorded verbatim in L0 without asserting it as a confirmed value. Verification-piece identity remains uncertain as in prior frames.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0226",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1417.2,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1400.3,
     "statement": "Close, look right there, that's how, teeth are right there so we're gonna do, open, and",
     "category": "prosthetic_plan"
    },
    {
     "time": 1418.82,
     "statement": "the bone is back so we're gonna do, okay, so all gonna be this, 3/5's.",
     "category": "measurement"
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Closer view, left side, of the seated lower denture in occlusion against the upper teeth; final look at occlusion before profiling and abutment placement.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "removable partial denture",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "denture clasp",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "lower lip",
    "oral mucosa",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds the lower lip down to show the seated denture in occlusion",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The same bite check, closer up and from the left side: it can be seen how the denture teeth meet the upper teeth. This is the last look at the occlusion before moving on to profiling and abutment placement.",
   "L5_clinical_context": "On the left, an upper premolar/molar with a gold crown and a cast clasp; below, the edge of the denture rests on the ridge mucosa. It is important that the future framework not raise the bite and that the screw channels not exit onto the facial surface of the teeth.",
   "uncertainty": "The transcription ‘3/5's’ is not confirmed and is not used as a number. The fit of the denture against the ridge and the position of the implants underneath it cannot be assessed from the frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0296",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1747.8,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1743.58,
     "category": "technique",
     "statement": "Now we are going to tighten this one again, just to check."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "multi-unit abutment step, mandibular anterior ridge; view mostly occluded by gloved fingers and tongue, one abutment partly visible at left",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "mandibular alveolar ridge",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "Continuation of the abutment re-tightening/check step; the tongue and gloved fingers dominate the frame, limiting the view of the ridge itself.",
   "L5_clinical_context": "Part of the multi-unit abutment torque-check sequence on the mandibular arch.",
   "uncertainty": "Only one abutment-like object is partly visible; exact site and instrument-tissue contact cannot be confirmed given the occlusion by gloved fingers and tongue.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0252",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1778.0,
   "phase_index": 5,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1788.06,
     "category": "prosthetic_plan",
     "statement": "Okay, so we'll do white caps."
    }
   ],
   "L1_phase_normalized": "multiunit_abutments",
   "L1_phase_detailed": "Final look at the arch before the transition to placing healing caps: a gloved finger points near the maxillary molar area, and a nasal oxygen cannula is visible on the patient's face; the mandibular abutment row itself is occluded by the fingers in this frame.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "chin",
    "nose",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "points to",
     "maxillary teeth"
    ]
   ],
   "L4_reasoning": "This frame marks the close of the multi-unit abutment torque-check sequence, immediately before the surgeon states the plan to place healing caps next (captured in the wider speech context, 10 seconds after this frame).",
   "L5_clinical_context": "healing caps are placed on multi-unit abutments after torque verification, typically ahead of a PIC/digital scan of the arch; the nasal oxygen cannula confirms the patient remains under conscious sedation rather than general anesthesia, consistent with the case description.",
   "uncertainty": "The mandibular abutment row itself is occluded by the gloved fingers in this frame, so its exact state (fully tightened, caps not yet placed) cannot be directly confirmed from the image - only from the adjacent speech a few seconds later.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0253",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1789.0,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1788.06,
     "category": "materials",
     "statement": "Okay, so we'll do white caps."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Start of the cap-placement step on the mandibular ridge: several multi-unit abutments are exposed and still uncapped, OptraGate retractor holding the mouth open, right after the surgeon announces the white-cap plan.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ],
    [
     "multi-unit abutment",
     "protrudes from",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The surgeon has just announced that white caps will be placed on the multi-unit abutments now that all implants are seated; this frame is the moment right before cap placement begins, with the abutments still bare metal.",
   "L5_clinical_context": "Multi-unit abutments (Nobel Biocare, titanium-nitride coated) sit in the mandibular ridge between the mental foramina; the antagonist maxillary arch, including a gold/metal crown on a posterior tooth, is visible below for reference.",
   "uncertainty": "An indistinct curved metal object is visible at the top edge of the frame; it could not be identified with any confidence and is not labeled. Exact number of abutments fully exposed cannot be confirmed due to blood and tissue overlap.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0306",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1798.4,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Cap-placement step in progress on the mandibular ridge; surgeon's fingers and a handheld instrument are working at the right side of the arch, shortly after announcing white caps will be used.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "lower lip",
    "gingiva"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "manipulates",
     "mandibular alveolar ridge"
    ],
    [
     "implant driver",
     "engages",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Continuing the cap-seating work just announced ('we'll do white caps'); the surgeon is actively fitting a component onto an abutment on the mandibular ridge, partly occluded by the working hand.",
   "L5_clinical_context": "Nobel Biocare healing caps are being fitted onto multi-unit abutments already placed on the implants; the mandibular ridge is mostly hidden behind the working fingers at this instant.",
   "uncertainty": "The exact instrument tip and whether a cap is already seated at this site cannot be confirmed; view of the mandibular ridge is largely blocked by the gloved fingers.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0313",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1823.2,
   "phase_index": 6,
   "image_quality": "degraded",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Motion-blurred frame; a sliver of the lip retractor is visible but the mandibular field is not resolved.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "upper lip"
   ],
   "L3_triplets": [],
   "L4_reasoning": "Occurs during the same cap-seating stretch as neighboring frames; content cannot be further specified due to blur.",
   "L5_clinical_context": "Part of the caps-and-summary phase; no clinical detail beyond retractor position is extractable.",
   "uncertainty": "Frame is degraded/blurred; mandibular ridge, caps, and instruments cannot be identified with confidence.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0261",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1824.6,
   "phase_index": 6,
   "image_quality": "degraded",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Heavily blurred, degraded-quality frame; gloved hands obscure nearly the entire field with only a small indistinct sliver of tissue visible, consistent with continued manipulation at the cap sites.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [],
   "L3_triplets": [],
   "L4_reasoning": "Likely a continuation of the cap-seating work, but the specific action is not distinguishable due to severe blur and degraded image quality.",
   "L5_clinical_context": "Not assessable from this frame.",
   "uncertainty": "Image quality is degraded and heavily motion-blurred; only gloved hands and an indistinct sliver of tissue are visible, insufficient to confirm any anatomy or specific instrument beyond the gloves themselves.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0314",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1825.2,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Clear view of fingers and a driver-like instrument positioned at the mandibular ridge, continuing cap seating; upper arch crowns visible above.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engages",
     "multi-unit abutment"
    ],
    [
     "gloved hand",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Continued fitting of caps onto the mandibular multi-unit abutments.",
   "L5_clinical_context": "Nobel Biocare cap-seating step in this All-on-4 mandible reconstruction.",
   "uncertainty": "Cannot confirm exact cap type (comfort vs. scanning) being placed at this specific site.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0262",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1826.6,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Two white caps now visible seated on multi-unit abutments in the mandibular ridge; a thin metal instrument is being used to check/position the caps, remaining abutments still uncapped.",
   "L2_instruments": [
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "checks",
     "healing cap"
    ],
    [
     "healing cap",
     "covers",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Progressive cap seating continues; two of the five abutments now carry white caps, consistent with the surgeon's stated plan.",
   "L5_clinical_context": "The mandibular ridge shows a mix of capped and uncapped multi-unit abutments; the antagonist maxillary arch with an existing gold crown remains visible below for reference.",
   "uncertainty": "Cannot determine which specific caps are comfort-type versus scanning-type from appearance alone; the thin instrument's exact identity is not fully certain.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0315",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1830.0,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Wide clear view of the mandibular ridge: two healing caps are now visible in place, with a darker uncapped component at the left end of the ridge.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ],
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "This frame documents visible progress of the cap-placement step: multiple white caps are now seated on the mandibular implants, matching the surgeon's plan to fit white caps for scanning.",
   "L5_clinical_context": "5 implants were placed in this mandible; white Nobel Biocare caps are chosen because their color is picked up well by the subsequent intraoral/PIC scan.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0263",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1831.0,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Manual retraction of the cheek/lip continues; one white cap is visible at the implant site while the rest of the ridge is largely obscured by fingers.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "lower lip",
    "upper lip",
    "gingiva",
    "chin"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "Continued manual retraction while caps are checked/seated; only a partial view of the capped abutment site is available.",
   "L5_clinical_context": "One visible white cap confirms ongoing progress of the capping sequence begun earlier in the phase.",
   "uncertainty": "Most of the implant/cap site is obscured by fingers; the full cap count cannot be assessed from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0316",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1833.6,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Similar wide view; fingers retract tissue while at least two white caps remain visible on the mandibular ridge.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "gingiva"
    ],
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Continuing documentation of the caps already seated on the mandibular ridge during this phase.",
   "L5_clinical_context": "Cap-seating step for the All-on-4 mandible restoration, Nobel Biocare components.",
   "uncertainty": "Precise count and type (comfort vs scanning) of caps present cannot be fully resolved from this angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0317",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1836.4,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Fingers press tissue near the mandibular ridge; white caps remain visible, continuing the same cap-placement sequence.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "mandibular alveolar ridge",
    "gingiva"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "presses",
     "gingiva"
    ],
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Ongoing cap placement; surgeon manipulating tissue around the already-seated caps.",
   "L5_clinical_context": "Part of the sequential Nobel Biocare white-cap fitting on the mandibular multi-unit abutments.",
   "uncertainty": "Cannot confirm the exact number of caps present at this instant or their individual type.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0264",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1837.0,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Three white caps now seated in a row across adjacent mandibular abutments, with one abutment still bare metal (rightmost); caps being fitted along the ridge, matching the surgeon's description of white healing caps.",
   "L2_instruments": [
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "covers",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Matches the surgeon's spoken description of placing white caps across the multi-unit abutments; three are now capped and one remains bare, consistent with sequential capping across the five implant sites.",
   "L5_clinical_context": "Nobel Biocare healing caps are both white, chosen so they are clearly visible on the subsequent PIC intraoral scan; the antagonist maxillary arch, including an existing gold crown, is visible below for reference.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0318",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1841.4,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Fingers occlude most of the mandibular field; a thin instrument tip is visible between them, still within the cap-placement sequence.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engages",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Continuation of cap fitting; specific site not resolvable due to occlusion.",
   "L5_clinical_context": "Nobel Biocare cap-seating step, All-on-4 mandible.",
   "uncertainty": "Mandibular ridge and cap status not visible; instrument identity uncertain.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0265",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1841.6,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Manual retraction of cheek/lip; a single white cap is visible at the implant site while the rest of the ridge is obscured by fingers, around the time the surgeon explains the two cap types.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "lower lip",
    "upper lip",
    "gingiva",
    "chin"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Frame is close to the surgeon's detailed explanation of the cap types (comfort vs. scanning); one cap is visible, consistent with ongoing placement.",
   "L5_clinical_context": "Cap placement on the mandibular multi-unit abutments continues; full ridge view is obstructed by manual retraction.",
   "uncertainty": "Most of the implant/cap site is obscured by fingers; total cap count cannot be confirmed in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0319",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1845.6,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Fingers occlude the ridge; the surgeon is describing the caps just placed. (In the OR he names sub-types — 'white caps, two comfort caps and also the scanning caps', kept verbatim in L0 — but his 2026-08-05 answer identifies all five as the same Nobel Biocare multi-unit abutment healing cap.)",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "doctor_mentioned",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "implant driver",
     "engages",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "The surgeon is describing the caps just placed; visually only a driver/instrument at the ridge is resolvable at this exact instant. His OR wording distinguishes sub-types (kept verbatim in L0); his 2026-08-05 answer identifies all five as the same healing cap.",
   "L5_clinical_context": "Nobel Biocare's multi-unit abutment component kit contains both comfort caps (for soft-tissue healing) and white scanning caps (for the PIC/intraoral scan); the surgeon confirmed on 2026-08-05 that what is on all five positions in this case is the healing cap, one type throughout.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0320",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1850.0,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Fingers press near the left crown/abutment area; continuing right after the surgeon's statement about the caps just placed.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "doctor_mentioned",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Continuing from the surgeon's just-spoken description of the cap types now in place on the mandibular arch.",
   "L5_clinical_context": "Case now has Nobel Biocare multi-unit abutment healing caps across all 5 mandibular implants — one and the same component on every position (surgeon, 2026-08-05).",
   "uncertainty": "The mandibular ridge itself is not clearly visible in this frame to confirm the caps directly; reliant on the doctor's statement for the cap-type detail.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0321",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1856.4,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    },
    {
     "time": 1859.06,
     "category": "safety",
     "statement": "So, let's do the summary before we close. We're going to rinse and close, but this is the nerve."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Wide view of the mandibular ridge showing three white caps in place plus an additional uncapped/dark component at the left; the surgeon begins the case summary, noting the nerve is bypassed.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ],
    [
     "gloved hand",
     "points at",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "This frame accompanies the start of the surgeon's verbal case summary ('let's do the summary before we close... this is the nerve'), in which he begins describing the safety margin kept from the mental nerve while pointing along the ridge where the caps now sit.",
   "L5_clinical_context": "5 implants (4.3x13 mm) were placed avoiding the mental nerve/mental foramina bilaterally; the multi-unit abutments now carry white Nobel Biocare caps in preparation for the scan.",
   "uncertainty": "Cannot confirm whether all implant sites are already capped; the leftmost dark component's exact identity (bare abutment vs. different cap) is unclear.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0266",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1859.4,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    },
    {
     "time": 1859.06,
     "category": "safety",
     "statement": "So, let's do the summary before we close. We're going to rinse and close, but this is the nerve."
    },
    {
     "time": 1863.06,
     "category": "safety",
     "statement": "We bypass the nerve, the implant like this, this implant like that, here, here, same thing there, away from those nerves."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Four multi-unit abutments now carry white caps in a neat row along the mandibular ridge; this frame corresponds to the surgeon beginning the spoken case summary and the safety statement about bypassing the mental nerve during implant placement.",
   "L2_instruments": [
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "mental nerve",
    "lower lip",
    "upper lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "covers",
     "multi-unit abutment"
    ],
    [
     "dental implant",
     "placed away from",
     "mental nerve"
    ]
   ],
   "L4_reasoning": "This is the surgeon's spoken case-summary moment: after placing white healing caps on the multi-unit abutments, the surgeon reviews implant positioning relative to the mental nerve on both sides, emphasizing that each implant was placed to bypass/avoid the nerve -- a key safety point given the mandible's proximity to the inferior alveolar/mental nerve.",
   "L5_clinical_context": "All visible Nobel Biocare multi-unit abutments in the mandibular ridge are now capped with white healing caps; the surgeon references the mental nerve (near the mental foramina) to confirm safe implant trajectories bypassing the nerve on both sides, consistent with the case's 5 x 4.3x13 mm implant plan.",
   "uncertainty": "The mental nerve itself is not distinctly resolvable as a separate structure in the image; its listing is inferred from the near-simultaneous narration (delta -0.3s) rather than direct visual confirmation of the nerve.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0322",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1860.2,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": 5,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1848.06,
     "category": "materials",
     "statement": "You need to tell them. So, these are white caps, two comfort caps and also the scanning caps."
    },
    {
     "time": 1859.06,
     "category": "safety",
     "statement": "So, let's do the summary before we close. We're going to rinse and close, but this is the nerve."
    },
    {
     "time": 1863.06,
     "category": "safety",
     "statement": "We bypass the nerve, the implant like this, this implant like that, here, here, same thing there, away from those nerves."
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Wide view showing four white caps now seated across the mandibular ridge; surgeon is mid-summary, stating the nerve is bypassed at each implant site.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "upper lip",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ],
    [
     "gloved hand",
     "points at",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Full complement of caps visible on the mandibular ridge, coinciding with the safety statement about routing each implant away from the mental nerve on both sides.",
   "L5_clinical_context": "Safety statement: implants placed to bypass the mental nerve bilaterally; caps now fully seated on all mandibular multi-unit abutments, matching the case_facts of 5 implants placed.",
   "uncertainty": "Exact identity (comfort vs. scanning) of each individual cap cannot be determined visually; relies on the doctor's verbal breakdown.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0269",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1899.6,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1893.06,
     "category": "materials",
     "statement": "They're just very good for scanning. They're white, so the scan picks them up real nice, and we have a matching software for those components."
    },
    {
     "time": 1902.06,
     "category": "technique",
     "statement": "So now, since we did this incision here, which is a vertical releasing incision in the midline,"
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "A finger points toward antibiotic powder/residue over the mandibular ridge while a metal cup is held nearby; the surgeon's narration transitions from the caps-and-summary discussion toward describing the vertical releasing incision, marking the approach of the closure/suturing phase.",
   "L2_instruments": [
    {
     "name": "antibiotic powder",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [
    "metal medicine cup"
   ],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "chin",
    "nose"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "points to",
     "mandibular alveolar ridge"
    ],
    [
     "antibiotic powder",
     "covers",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "This frame marks the end of the caps-and-summary phase: the surgeon finishes explaining the healing caps' purpose (white color for scan visibility and matching software) and begins describing the vertical releasing incision used for the flap, signaling the transition to wound closure.",
   "L5_clinical_context": "White Nobel Biocare healing caps are chosen specifically for their visibility on the post-op PIC scan and compatibility with matching prosthetic-design software; the surgical field shows antibiotic powder residue over the ridge just before closure begins.",
   "uncertainty": "The exact number of caps still visible beneath the powder cannot be confirmed; the metal cup's specific function is inferred, not certain.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0327",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1901.8,
   "phase_index": 6,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1893.06,
     "category": "materials",
     "statement": "They're just very good for scanning. They're white, so the scan picks them up real nice, and we have a matching software for those components."
    },
    {
     "time": 1902.06,
     "category": "technique",
     "statement": "So now, since we did this incision here, which is a vertical releasing incision in the midline,"
    }
   ],
   "L1_phase_normalized": "caps_and_summary",
   "L1_phase_detailed": "Final frame of this phase: wide view of the mandibular ridge with caps and blood, a curved instrument and applicator still in the field, right at the transition into the surgeon's description of the releasing incision, marking the end of the caps-and-summary segment.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "syringe",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ],
    [
     "periosteal elevator",
     "retracts",
     "gingiva"
    ]
   ],
   "L4_reasoning": "Marks the end of the caps-and-summary phase, immediately preceding the surgeon's statement about the vertical releasing incision in the midline, which begins the transition toward flap closure.",
   "L5_clinical_context": "All mandibular implant sites now carry Nobel Biocare caps (healing caps) in preparation for the scan; the case is moving into the closure phase with mention of the releasing incision and forthcoming suturing.",
   "uncertainty": "Cannot confirm exact cap count/type distribution at each site; the transition statement about the incision belongs mostly to the following closure phase rather than this one.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0270",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1903.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1902.06,
     "category": "technique",
     "statement": "So now, since we did this incision here, which is a vertical releasing incision in the midline,"
    },
    {
     "time": 1888.06,
     "category": "materials",
     "statement": "So those are Nobel Biocare white caps, and we like them because everything is new then except for those caps."
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing just beginning; surgeon indicating the freshly made midline vertical releasing incision on the mandibular ridge, immediately before starting closure",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "periosteal elevator",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "lower lip",
    "chin"
   ],
   "L3_triplets": [
    [
     "periosteal elevator",
     "retracts",
     "mucoperiosteal flap"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "This is the transition moment from incision to closure: the surgeon is pointing out the vertical releasing incision he just made at the midline before beginning to suture it.",
   "L5_clinical_context": "Midline vertical releasing incision on the mandibular ridge adjacent to a row of white caps marking the five implant sites; the incision allows tension-free flap advancement for closure over the ridge.",
   "uncertainty": "The thin metal instrument held near the incision cannot be confirmed as a periosteal elevator versus a probe/explorer from this angle. The clear tube near the chin is assumed to be a nasal oxygen cannula rather than suction tubing, but this is not certain from the image alone.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0328",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1905.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 1893.06,
     "category": "materials",
     "statement": "They're just very good for scanning. They're white, so the scan picks them up real nice, and we have a matching software for those components."
    },
    {
     "time": 1902.06,
     "category": "technique",
     "statement": "So now, since we did this incision here, which is a vertical releasing incision in the midline,"
    },
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, midline vertical releasing incision being folded back and a horizontal mattress suture being initiated, anterior mandible over the row of healing caps",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "needle holder",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "passes suture through",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The midline releasing incision is being folded back into position and a horizontal mattress suture is being placed to secure and evert the flap margins, giving tension-free primary closure over the healing caps.",
   "L5_clinical_context": "Anterior mandible between the mental foramina; flap closure follows placement of the Nobel Biocare healing caps on the multi-unit abutments; the horizontal mattress technique everts wound edges to reduce dead space and improve healing over the implant sites.",
   "uncertainty": "A shiny metal instrument is visible near the right cheek/molar but its exact identity (mirror, probe, or retractor) cannot be determined from this frame. Exact number of caps and sutures already placed is not confirmable from a single image.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0272",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1912.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, horizontal mattress suture being tightened across the midline incision, mandibular ridge",
   "L2_instruments": [
    {
     "name": "needle holder",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "manipulates",
     "suture thread"
    ]
   ],
   "L4_reasoning": "Continuation of the horizontal mattress suture placement described a moment earlier; the surgeon is working the thread through the flap edges.",
   "L5_clinical_context": "Suture closure over the midline incision on the mandibular ridge; white caps partially visible below the working area.",
   "uncertainty": "The instrument held vertically is mostly out of focus; whether it is the needle holder itself or a separate probe cannot be confirmed with certainty.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0329",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1913.4,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1902.06,
     "category": "technique",
     "statement": "So now, since we did this incision here, which is a vertical releasing incision in the midline,"
    },
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, horizontal mattress suture thread bridging the midline incision after flap folding, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "spans",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Continuation of the horizontal mattress suture placement across the midline releasing incision; the thread bridges the flap edges before the knot is tied.",
   "L5_clinical_context": "Anterior mandible; horizontal mattress sutures evert wound margins over the implant healing caps to promote tension-free closure.",
   "uncertainty": "The hand tensioning the thread is blurred at the frame edge; cannot confirm whether an instrument or fingers alone are being used at this instant.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0273",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1914.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, horizontal mattress suture, thread visible looping across the midline incision, mandibular ridge",
   "L2_instruments": [
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "chin"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "spans",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "Close view of the suture thread mid-pass through the flap, consistent with the horizontal mattress stitch the surgeon just described placing.",
   "L5_clinical_context": "Suture line crossing the midline incision over the implant site row; caps visible below the thread.",
   "uncertainty": "Image is close and slightly soft-focus on the working hand; the exact instrument at the top of frame is not clearly identifiable.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0330",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1915.4,
   "phase_index": 7,
   "image_quality": "degraded",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Camera/hand motion blur obscures the surgical field; by timestamp this falls within suturing of the midline incision, anterior mandible",
   "L2_instruments": [],
   "L2_other": [],
   "anatomy_visible": [],
   "L3_triplets": [],
   "L4_reasoning": "",
   "L5_clinical_context": "",
   "uncertainty": "Frame is dominated by motion blur (hand and/or camera movement); the mandibular surgical site, sutures, and any instruments cannot be assessed from this frame.",
   "no_surgical_field": true
  },
  {
   "keyframe_id": "sony_lateral_0274",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1917.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, needle holder passing thread near the midline incision, white chalky material visible along the ridge crest consistent with antibiotic powder placed under the flap",
   "L2_instruments": [
    {
     "name": "needle holder",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "antibiotic powder",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "chin"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "holds",
     "suture thread"
    ],
    [
     "antibiotic powder",
     "applied to",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The needle holder is guiding thread through the incision line; the white powdery material along the ridge crest is consistent with the antibiotic powder the surgeon mentioned placing under the flap earlier in this segment.",
   "L5_clinical_context": "Antibiotic powder under the flap is a prophylactic measure against surgical site infection prior to full closure over the implant sites.",
   "uncertainty": "The white material on the ridge could alternatively be residual bone debris or coagulum rather than antibiotic powder; this cannot be distinguished with certainty from the image.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0331",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1917.4,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, horizontal mattress suture thread spanning the midline incision over the row of healing caps, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "gingiva"
    ],
    [
     "suture thread",
     "spans",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The surgeon retracts the flap margin manually while the mattress suture thread remains tensioned across the incision, prior to tying the knot.",
   "L5_clinical_context": "Anterior mandible with five Nobel Biocare healing caps visible on the multi-unit abutments beneath the mucosa; correct flap eversion is important to avoid dehiscence over the implant sites.",
   "uncertainty": "Cannot confirm from this frame whether the thread has already been tied or is still being positioned.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0275",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1919.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    },
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, two gloved hands managing suture thread over the mandibular ridge, partial view of caps",
   "L2_instruments": [
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "manipulates",
     "suture thread"
    ]
   ],
   "L4_reasoning": "The surgeon is describing the suture material's properties (a strong, natural suture that aligns the tissue) while actively working the thread through the flap.",
   "L5_clinical_context": "Choice of a natural, high-tensile suture material for the midline closure is intended to hold the flap in alignment over the implant sites without excessive tension.",
   "uncertainty": "Only three of the five caps are visible in this frame; the other two are occluded by the hands. Exact suture material (e.g. gut vs silk) is not specified in the transcript excerpt available.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0332",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1919.6,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, gloved hand moving across the field to adjust the flap/suture near the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "adjusts",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The surgeon's hand moves across the field, likely adjusting the flap or suture tension as part of completing the horizontal mattress stitch.",
   "L5_clinical_context": "Anterior mandible midline incision; careful flap handling avoids tearing the thin mucosa adjacent to the healing caps.",
   "uncertainty": "Motion blur on the gloved hand obscures whether an instrument is being held; the exact action (grasping tissue vs. repositioning the suture) cannot be confirmed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0333",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1927.6,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    },
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, discussing suture material properties while finishing the horizontal mattress suture over the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "secures",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The surgeon comments on the suture material (described as strong and natural) while completing the mattress stitch across the midline incision.",
   "L5_clinical_context": "The suture referenced is likely a natural, high-tensile material chosen for reliable approximation; correct suturing here approximates the flap over the anterior implant sites without tension.",
   "uncertainty": "The exact suture material/brand is not specified by the surgeon in this segment and cannot be confirmed visually.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0276",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1929.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    },
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, retractor being repositioned, hands mostly out of focus over the mandibular ridge",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Brief repositioning moment during ongoing suturing of the midline incision; hands are blurred, consistent with active manipulation between stitches.",
   "L5_clinical_context": "Continuing closure of the midline incision over the implant site row on the mandibular ridge.",
   "uncertainty": "The blurred hands in the lower part of the frame obscure most instrument detail; only partial view of the caps is possible.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0334",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1929.6,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    },
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, horizontal mattress suture being tied over the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "ties",
     "suture thread"
    ]
   ],
   "L4_reasoning": "The knot-tying step of the horizontal mattress suture appears underway, consistent with the surgeon's simultaneous comments on suture material strength.",
   "L5_clinical_context": "Anterior mandible; secure knot placement is essential to prevent premature loosening of the mattress suture over the healing caps.",
   "uncertainty": "The precise moment of knot completion versus tensioning cannot be distinguished because the hand partly obscures the site.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0277",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1932.4,
   "phase_index": 7,
   "image_quality": "degraded",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, mandibular ridge, frame heavily motion-blurred during instrument/hand movement",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "chin"
   ],
   "L3_triplets": [],
   "L4_reasoning": "This frame falls during a fast hand movement in the ongoing suturing sequence; the strong motion blur prevents identifying a specific action.",
   "L5_clinical_context": "Same suturing sequence over the midline mandibular incision as the surrounding frames; no additional clinical detail can be read from this frame specifically.",
   "uncertainty": "Heavy motion blur makes almost all instrument and tissue detail indeterminate in this frame; only a faint suture thread and gloved hands can be made out. Quality flagged as degraded.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0335",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1932.6,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1909.3,
     "category": "technique",
     "statement": "we're going to fold that first, do this, we're going to do a little horizontal mattress here,"
    },
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, horizontal mattress suture being finished near the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "secures",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "Suturing of the midline incision continues; the visible thread indicates an in-progress or just-completed mattress stitch while the surgeon describes the suture material.",
   "L5_clinical_context": "Anterior mandible; consistent flap approximation over each healing cap is required across the full width of the incision.",
   "uncertainty": "An additional instrument is partially visible near the gloved hand at the upper right but its type (scissors, forceps, or needle holder) cannot be confirmed from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0336",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1935.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, hand and shadow obscure most of the site while a suture is being managed at the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "probable",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "manipulates",
     "suture thread"
    ]
   ],
   "L4_reasoning": "Hand and instrument activity over the suture site suggests ongoing knot tying or thread management for the mattress suture; the exact step is unclear due to shadow and obstruction.",
   "L5_clinical_context": "Anterior mandible midline incision continues to be managed; adequate visibility is important for precise suturing near the healing caps.",
   "uncertainty": "A large gloved hand and shadow obscure most of the surgical site; the specific instrument and exact suturing step cannot be confirmed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0278",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1936.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, mandibular ridge, retractor held steady, blurred hand mid-stitch",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "chin"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Retractor is being held in place to keep the surgical field open while the suturing hand works, mid-motion, on the mandibular ridge.",
   "L5_clinical_context": "Ongoing closure of the midline incision; two caps are partly visible through the blur.",
   "uncertainty": "The moving hand is blurred enough that the instrument it holds cannot be identified.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0337",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1938.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, horizontal mattress suture visible across the midline incision with healing caps exposed, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "spans",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The mattress suture thread remains visible spanning the incision, consistent with ongoing tensioning or tying while the surgeon discusses the suture material.",
   "L5_clinical_context": "Anterior mandible; visualization of the caps confirms the implant positions are undisturbed by the suturing process.",
   "uncertainty": "Cannot confirm whether the knot for this particular stitch has been completed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0279",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1940.8,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    },
    {
     "time": 1949.06,
     "category": "technique",
     "statement": "reverse the tissue a little bit"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, second gloved hand in a different (pink/salmon) glove color joins to help manage the suture thread and retractor, mandibular ridge",
   "L2_instruments": [
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds",
     "suture thread"
    ]
   ],
   "L4_reasoning": "A second team member (distinct glove color) appears to be assisting with tissue/retractor management while the surgeon continues suturing, consistent with 'reverse the tissue a little bit'.",
   "L5_clinical_context": "Team assistance during flap re-approximation over the midline incision on the mandibular ridge.",
   "uncertainty": "It is not certain whether the pink-gloved hand belongs to a second surgeon or a surgical assistant; the caps are almost entirely occluded in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0338",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1941.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, continued horizontal mattress suture placement over the midline incision, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "secures",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "Progression of suturing continues along the midline incision; flap margins remain approximated over the healing caps.",
   "L5_clinical_context": "Anterior mandible; maintaining flap position over the abutment sites reduces risk of exposure or infection.",
   "uncertainty": "The exact stitch count completed so far cannot be determined from a single frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0280",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1942.8,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    },
    {
     "time": 1949.06,
     "category": "technique",
     "statement": "reverse the tissue a little bit"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, clear view of five white caps in a row along the mandibular ridge with suture thread crossing over them, midline area",
   "L2_instruments": [
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "metal retractor blade",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood",
    "maxillary teeth",
    "chin"
   ],
   "L3_triplets": [
    [
     "suture thread",
     "spans",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "A clean, unobstructed view of the row of five white caps confirms the five implant sites (matching the case's 5 x 4.3x13mm implant plan) as the suture line is drawn across the ridge.",
   "L5_clinical_context": "Five white caps mark the implant/abutment positions across the mandibular arch (All-on-4/X design uses distal-most sites plus intermediate sites); care is taken not to snag the caps while passing the suture.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. The surgeon's own description of these caps a few minutes earlier as being for scanning ('white, so the scan picks them up real nice... matching software') supports the 'healing cap' label used here.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0339",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 1943.2,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Suturing, needle holder actively engaging the tissue at the midline incision site, anterior mandible",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "needle holder",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "keratinized gingiva",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "grasps",
     "gingiva"
    ],
    [
     "needle holder",
     "passes suture through",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The needle holder is being used to pass or tighten the suture through the flap edge, continuing the horizontal mattress technique to secure the incision.",
   "L5_clinical_context": "Anterior mandible; correct needle holder technique ensures even bites of tissue on both sides of the incision for a symmetric mattress stitch.",
   "uncertainty": "The exact suture bite (entry/exit point) cannot be fully traced due to the viewing angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0281",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 1944.8,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": 6,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 1928.52,
     "category": "materials",
     "statement": "So this is a very powerful suture, it aligns everything, and it's a natural suture so it"
    },
    {
     "time": 1949.06,
     "category": "technique",
     "statement": "reverse the tissue a little bit"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, needle holder inserting suture near the caps, midline mandibular ridge",
   "L2_instruments": [
    {
     "name": "needle holder",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture needle",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "blood"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "passes",
     "suture needle"
    ],
    [
     "suture needle",
     "penetrates",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The needle holder is placing another stitch immediately adjacent to the caps, continuing the closure of the midline incision.",
   "L5_clinical_context": "Suturing directly next to the implant/abutment caps requires care not to loosen or dislodge them while achieving flap closure.",
   "uncertainty": "Four of the five caps are visible in this frame; whether the fifth is out of frame or occluded by tissue cannot be determined.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0393",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2219.4,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2206.16,
     "category": "observation",
     "statement": "Did you call?"
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Clear working view: needle holder at upper left with visible tip, maxillary crowns and teeth above, tongue in the center, four healing caps with suture thread crossing them below.",
   "L2_instruments": [
    {
     "name": "needle holder",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture needle",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "tongue",
    "lower lip",
    "upper lip",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "needle holder",
     "passes through",
     "mucoperiosteal flap"
    ]
   ],
   "L4_reasoning": "The surgeon resumes active suturing across the healing-cap sites after the brief off-topic exchange, continuing the interrupted-suture closure.",
   "L5_clinical_context": "Anterior mandibular closure over the five implant sites; suture progress appears similar to earlier frames with all four visible caps encircled by thread.",
   "uncertainty": "Cannot confirm the exact count of completed knots at this point in the sequence.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0334",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2238.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2231.2,
     "category": "observation",
     "statement": "I like this chair, it's nice."
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "suturing, anterior mandible, assistant's fingers directly pinch/retract the gingiva near the abutment row while the surgeon's needle holder works above",
   "L2_instruments": [
    {
     "name": "needle holder",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "gingiva"
    ],
    [
     "needle holder",
     "positioned above",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The assistant is using bare gloved fingers rather than an instrument to hold the gingiva open, giving the surgeon direct access for the next stitch.",
   "L5_clinical_context": "Anterior mandibular closure over the abutment row continues; the antagonist gold-crowned maxillary molar remains visible as a fixed landmark.",
   "uncertainty": "Cannot confirm exact site of the next stitch or whether the needle holder is mid-throw.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0469",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2549.8,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2542.72,
     "category": "milestone",
     "statement": "antibiotic including this vancomycin irrigation. So we placed five implants and we can deliver"
    },
    {
     "time": 2550.84,
     "category": "observation",
     "statement": "the up report from this recording."
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "post-suturing cleanup, gauze wiping of the oral cavity at the conclusion of the case",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa",
    "chin"
   ],
   "L3_triplets": [
    [
     "gauze",
     "wipes",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "A large gauze is being swept across the arch, consistent with a final wipe-down of blood and irrigation fluid immediately after suturing is completed, timed with the surgeon's closing summary.",
   "L5_clinical_context": "Final gauze wipe-down of the oral cavity at the conclusion of the case, coinciding with the surgeon's closing summary that implants were placed (transcript 'we played five implants', corrected per case facts to 'we placed five implants') and that an operative report will be delivered from this recording.",
   "uncertainty": "Heavy motion blur and the gauze itself obscure most of the mandibular ridge, so the condition of the suture line and caps underneath cannot be assessed from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0394",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2550.0,
   "phase_index": 7,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2542.72,
     "category": "milestone",
     "statement": "antibiotic including this vancomycin irrigation. So we placed five implants and we can deliver"
    },
    {
     "time": 2550.84,
     "category": "observation",
     "statement": "the up report from this recording."
    }
   ],
   "L1_phase_normalized": "suturing",
   "L1_phase_detailed": "Post-suturing cleanup: gauze wiping the perioral area at the conclusion of the case, mandibular anterior arch.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "plastic suction tubing",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "oral mucosa",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "gauze",
     "wipes",
     "oral mucosa"
    ]
   ],
   "L4_reasoning": "A gauze is swept across the perioral area, consistent with a final wipe-down immediately after suturing/irrigation is completed, timed with the surgeon's closing case summary.",
   "L5_clinical_context": "Final gauze wipe-down at the conclusion of the case, coinciding with the surgeon's closing summary that implants were placed (transcript 'we played five implants', corrected per case facts to 'we placed five implants') and that an operative report will be delivered from this recording.",
   "uncertainty": "The gauze and hand obscure most of the mandibular ridge, so the condition of the suture line/healing caps underneath cannot be assessed from this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0470",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2552.2,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2542.72,
     "category": "milestone",
     "statement": "antibiotic including this vancomycin irrigation. So we placed five implants and we can deliver"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Mandibular arch immediately after the implant-placement wrap-up commentary; white caps in place over 3 of 5 visible implant sites; retraction/inspection prior to PIC scan setup.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "blood",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "The surgeon is verbally summarizing the just-completed implant placement (rotary speed, saline/antibiotic irrigation, 'we placed five implants') while the field is held open; this frame documents the mandibular arch state just before PIC scan preparation begins.",
   "L5_clinical_context": "Five 4.3x13mm implants have been placed in the mandible (All-on-4/X); the visible white dome caps protect the multi-unit abutments beneath. The two metal/gold-margined crowns at the top of frame belong to the maxillary arch (patient's own dentition, existing restorations) and must not be confused with mandibular abutment components.",
   "uncertainty": "Only 3 of 5 implant sites are visible in this framing. Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Known transcription error retained verbatim in L0: 'we played five implants' should read 'we placed five implants'.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0395",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2555.2,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2542.72,
     "category": "milestone",
     "statement": "antibiotic including this vancomycin irrigation. So we placed five implants and we can deliver"
    },
    {
     "time": 2550.84,
     "category": "observation",
     "statement": "the up report from this recording."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Just after placement of the five mandibular implants (surgeon's wrap-up statement, corrected transcription 'we placed five implants'); the ridge already carries protective white caps; OptraGate retractor in place; lateral view before the PIC-scan cap-to-marker exchange begins later in this batch.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "needle holder",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ],
    [
     "healing cap",
     "seated on",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The surgeon has just confirmed all five mandibular implants are placed; this frame documents the ridge state immediately afterward, with protective caps already seated, before the PIC-scan swap that follows a few dozen seconds later in the transcript.",
   "L5_clinical_context": "Five 4.3x13 mm Nobel Biocare implants placed in the mandible at 1200 rpm with saline and vancomycin irrigation (case_facts / nearby narration). The gold-coloured tooth on the natural maxillary arch is an existing restoration (antagonist), not a mandibular component - the two arches are not to be confused per batch rules.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. The dark two-pronged instrument visible at the top-left edge of frame is too small/blurred to confirm as needle holder vs. tissue forceps; labelled needle holder at probable confidence only.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0490",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2568.99,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2560.93,
     "category": "milestone",
     "statement": "So, okay, now we're ready for PIC scan."
    },
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Active cap-exchange moment: a gloved hand holding a hand instrument works at one implant site immediately after the instruction to 'remove the white covers and put a special plaque'; that site's cap appears altered/removed while the adjacent site still shows an intact white cap.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "probable",
     "source": "doctor_mentioned"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "removes",
     "healing cap"
    ],
    [
     "implant driver",
     "approaches",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "This frame captures the very start of the PIC scan preparation described in the immediately preceding narration: the surgeon removes each white cover and replaces it with a special scan marker/plaque before photogrammetric capture.",
   "L5_clinical_context": "PIC scan markers (referred to by the surgeon as a 'special plaque') are attached at each implant/abutment site in place of the healing caps so that the multi-camera photogrammetry system can register precise implant positions for the eventual prosthesis.",
   "uncertainty": "The exact hand tool cannot be positively identified (labeled 'implant driver' as closest vocabulary match; could alternatively be a small screwdriver for the cap/marker screw). It is not fully certain from the image whether the altered site already holds the PIC scan marker or is simply an exposed abutment platform without its cap.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0413",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2568.99,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2560.93,
     "category": "milestone",
     "statement": "So, okay, now we're ready for PIC scan."
    },
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "PIC scan initiation: the surgeon has just announced readiness for the PIC scan and instructs removal of the white covers to seat the special scanning plaque; two gloved hands are working at the mandibular ridge, one holding a small driver-type instrument.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "removes",
     "healing cap"
    ],
    [
     "implant driver",
     "engages",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "This frame captures the exact transition into the PIC scan workflow described in the phase evidence ('remove the white covers and put a special plaque'); the surgeon's hands are actively working the ridge caps at this moment, right after the milestone announcement.",
   "L5_clinical_context": "The white caps being removed here are what the surgeon calls the 'white covers'; a special scanning plaque/marker will be seated in their place at each site in turn, enabling the photogrammetric capture used to record implant position for prosthesis design.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. The exact instrument in hand (implant driver vs. a small screwdriver) cannot be fully resolved from this angle.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0491",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2573.39,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2560.93,
     "category": "milestone",
     "statement": "So, okay, now we're ready for PIC scan."
    },
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Continuation of cap-exchange manipulation; the view is largely occluded by the operator's gloved fingers close to the lens, with only the upper crowns and tongue clearly visible.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "probable",
     "source": "doctor_mentioned"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "manipulates",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The cap-exchange procedure continues; the working area itself is hidden behind the operator's fingers, consistent with close manual work at the implant sites.",
   "L5_clinical_context": "Same cap/marker exchange described in the preceding narration continues here, though the mandibular working site itself is not visible in this particular frame.",
   "uncertainty": "The mandibular implant sites and any specific cap or marker are not visible in this frame due to hand occlusion; a small dark object near the mouth corner cannot be identified with confidence.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0414",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2576.19,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Cap-to-marker exchange continuing; gloved fingers are manipulating an anterior mandibular implant site; the ridge view is partly obscured by the fingers.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "manipulates",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Continuation of the cap-removal/marker-seating instruction from the previous frame; fingers are working directly on an anterior implant site, consistent with the ongoing 'remove the white covers' instruction.",
   "L5_clinical_context": "Anterior mandibular implant site being handled during the cap-to-marker exchange; exact site and step (removal vs. seating) not fully clear due to finger occlusion.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Fingers occlude most of the ridge, so which specific site and which exact action (cap removal vs. marker seating) is in progress cannot be confirmed from this frame alone.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0492",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2576.79,
   "phase_index": 8,
   "image_quality": "degraded",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "View almost entirely occluded by the operator's gloved hand during cap-exchange manipulation; only a small blurred sliver of the retractor rim is visible.",
   "L2_instruments": [],
   "L2_other": [],
   "anatomy_visible": [],
   "L3_triplets": [],
   "L4_reasoning": "",
   "L5_clinical_context": "",
   "uncertainty": "Frame is almost entirely filled by a gloved hand at close range; no implant site, cap, or clear anatomy is assessable.",
   "no_surgical_field": true
  },
  {
   "keyframe_id": "lumix_overhead_0493",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2582.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Cap-exchange manipulation continues; the upper arch, tongue, and retractor rim are visible at the top of frame while the mandibular working site is occluded by the gloved hand.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "probable",
     "source": "doctor_mentioned"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "The cap-exchange step described in the narration ('remove the white covers and put a special plaque') is still underway; the specific mandibular site being worked on is hidden by the operator's hand.",
   "L5_clinical_context": "Consistent with the ongoing PIC scan marker exchange at the mandibular implant sites.",
   "uncertainty": "Mandibular implant site detail is not visible in this frame due to hand occlusion.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0415",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2583.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Gloved hands hold a small metal instrument/driver above the posterior-right mandibular implant site, consistent with seating or removing a cap/marker at that position during the PIC-scan exchange.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds",
     "implant driver"
    ],
    [
     "implant driver",
     "engages",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Continuation of the cap-to-marker exchange; hands are positioned over the posterior-right site with a small driver, matching the ongoing instruction to remove covers and place the scanning plaque.",
   "L5_clinical_context": "Posterior-right mandibular implant site being worked during the exchange; remaining sites on the left of the ridge still show white caps.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Cannot confirm from this instant whether this is cap removal or marker placement at the posterior-right site.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0494",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2584.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Cap-exchange manipulation continues; a cluster of white caps is visible at the mandibular sites along with the upper arch and tongue.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "certain",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "gloved hand",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "Several implant sites still retain their white covers while the exchange for PIC scan markers proceeds site by site.",
   "L5_clinical_context": "Consistent with the described sequence: covers are removed and replaced with scan markers one site at a time rather than all at once.",
   "uncertainty": "It is not certain from this frame alone whether any site already carries the PIC scan marker rather than its original cap; all visible caps in this frame appear white/domed.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0416",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2585.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    },
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "The posterior-right mandibular implant site now shows its cap removed (exposed, blood-tinged site) while the remaining ridge positions still carry their white caps; this is the moment just before the scanning marker (flag) is seated at that site.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "No hands in frame at this instant; the posterior-right site is visibly without its white cap, exposing the underlying tissue, immediately preceding the marker's appearance in the following frames.",
   "L5_clinical_context": "This is the clearest single frame showing the mid-exchange ridge state: one site bare, remaining sites still capped, matching the surgeon's narration of the scanning process about to start.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Whether the exposed posterior-right site is momentarily bare (about to receive the marker) or its cap simply fell out of frame view cannot be fully distinguished; the underlying abutment itself is not clearly resolvable through the blood-tinged tissue, so 'multi-unit abutment' is not asserted here.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0495",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2589.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    },
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Just before the 'we'll scan the body for the scanning process' statement; one implant site shows a darker cap/marker visually distinct from the remaining white domed caps, consistent with the PIC scan marker exchange in progress.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "PIC scan marker",
     "confidence": "probable",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "positions",
     "PIC scan marker"
    ]
   ],
   "L4_reasoning": "The team is approaching the point of actually capturing the photogrammetric scan; a visually distinct (darker) cap at one site is consistent with the PIC scan marker having been placed there while other sites still carry their original white covers.",
   "L5_clinical_context": "Mixed-state arch during marker exchange: some implant sites already fitted with the PIC scan marker/flag, others still with the original white cover, immediately preceding the scanning-body statement.",
   "uncertainty": "The darker cap cannot be confirmed with full visual certainty as the PIC scan marker versus a different cap/lighting artifact; classification here relies partly on the doctor's concurrent narration.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0417",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2589.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    },
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "A gloved hand positions an instrument/driver at the posterior-right mandibular implant site immediately before the scanning marker becomes visible in the following frames, concurrent with the surgeon's narration about starting the scanning process.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "implant driver",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "holds",
     "implant driver"
    ],
    [
     "implant driver",
     "engages",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Hand and driver are positioned exactly at the site that shows the PIC scan marker in the very next annotated frame, consistent with the marker being seated here.",
   "L5_clinical_context": "Posterior-right mandibular implant site receiving the PIC scan marker; remaining ridge sites still show white caps.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. The small metallic tip held near the site cannot be confirmed with certainty as the marker itself versus a separate driver tool.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0496",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2593.19,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2571.07,
     "category": "technique",
     "statement": "Yes, don't move, stay, just remove the white covers and put a special plaque, a special"
    },
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Immediately after the 'scan the body' statement; the view is again partly occluded by the operator's gloved hand positioning the site for the photogrammetric capture.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "doctor_mentioned",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "PIC scan marker",
     "confidence": "probable",
     "source": "doctor_mentioned"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "The operator is holding/positioning the field steady immediately after announcing the start of the scanning process, consistent with the wide-window instructions to 'stay open' seen in neighboring frames.",
   "L5_clinical_context": "This marks the practical start of the photogrammetric capture sequence for the mandibular implant sites.",
   "uncertainty": "Mandibular site detail is not visible in this frame due to hand occlusion; presence/absence of the PIC scan marker at each site cannot be confirmed visually here.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0497",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2595.19,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "PIC scan, extreme close-up on the maxillary anterior teeth and OptraGate retractor rim while a gloved hand manipulates something below; the mandibular ridge and implant sites are outside this tight framing.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "upper lip"
    ]
   ],
   "L4_reasoning": "Camera framing is too tight to show the implant sites; only the antagonist maxillary teeth and the retractor are visible while the cap/marker swap continues just out of frame below.",
   "L5_clinical_context": "Maxillary crowns visible here are the patient's own existing restorations (antagonist arch), not related to the mandibular implant work being performed below the frame.",
   "uncertainty": "The surgical field of interest (mandibular ridge, caps/markers) is entirely outside this frame's crop; no determination possible about which step of the swap is occurring.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0418",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2595.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": 7,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2590.07,
     "category": "technique",
     "statement": "So we'll scan the body for the scanning process."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "The PIC scan marker (black flag with a white dot pattern) is now seated at the posterior-right mandibular implant site; a gloved finger stabilises/checks an anterior site where a white cap remains; the scanning process is underway per the surgeon's narration.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "certain",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "upper lip",
    "lower lip",
    "chin",
    "nose",
    "blood"
   ],
   "L3_triplets": [
    [
     "PIC scan marker",
     "seated on",
     "mandibular alveolar ridge"
    ],
    [
     "gloved hand",
     "stabilizes",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The distinctive black-and-white dot-coded marker is now clearly and unambiguously seated at the posterior-right site, matching the surgeon's description of a 'special plaque' used for the scanning process; this is the clearest confirmation in this batch that the cap-to-marker exchange has occurred at that position.",
   "L5_clinical_context": "The coded marker allows the photogrammetry scan to register the exact 3D position of that implant site for prosthesis design; remaining anterior sites still carry white caps and have not yet been swapped.",
   "uncertainty": "The PIC scan marker itself is visually unmistakable (coded black/white pattern, unlike any plain white cap) so it is marked certain. Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. (applies to the remaining white-capped sites still visible on this ridge, which have not yet been exchanged).",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0502",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2625.99,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2620.07,
     "category": "technique",
     "statement": "Open, open, open."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "PIC scan, mandibular ridge visible: one black PIC scan marker is seated on the ridge, with a small white healing cap still visible beside it; tongue and maxillary crowns visible above, a thin strand of saliva connects tongue to ridge.",
   "L2_instruments": [
    {
     "name": "PIC scan marker",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "both",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "saliva",
    "blood",
    "keratinized gingiva"
   ],
   "L3_triplets": [
    [
     "PIC scan marker",
     "seats on",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Confirms one implant site now carries the scan marker while at least one neighbouring site still has its original cap, mid-way through the sequential swap the surgeon described.",
   "L5_clinical_context": "Mandibular ridge, 5 x 4.3x13 mm implants; only a subset of sites are visible from this camera angle at any one time.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0427",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2666.59,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2680.07,
     "category": "milestone",
     "statement": "Stampin', stampin'. That's number three."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "PIC scan, anterior mandible: gloved finger pressing a new scan marker into place at a third site, immediately preceding the surgeon's count of 'number three'.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "certain",
     "source": "both"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "lower lip",
    "upper lip"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "presses",
     "PIC scan marker"
    ]
   ],
   "L4_reasoning": "The finger is directly pressing a marker into a site, matching the 'stampin', stampin'' language (i.e. pressing/seating the marker) and the immediately following count of the third marker.",
   "L5_clinical_context": "Anterior mandible, All-on-4/X; this is the moment of seating the third of five scan markers.",
   "uncertainty": "Only two markers are clearly resolved as already-seated in this frame; the object being pressed into place is assumed to be the third marker based on the immediately following audio, but the frame alone does not confirm the count.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0520",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2772.19,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2770.07,
     "category": "technique",
     "statement": "Open, open."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "PIC scan capture, mandibular ridge: gloved hand touches/adjusts the left-side cluster of scan-marker flags while a further flag remains seated on the right; mouth held open by the OptraGate retractor",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "tongue",
    "mandibular alveolar ridge",
    "gingiva",
    "upper lip",
    "lower lip",
    "oral mucosa"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "adjusts",
     "PIC scan marker"
    ]
   ],
   "L4_reasoning": "The surgeon is nudging/verifying the seating of a flag on the left-side implant site while the patient is coached to keep the mouth open, so the marker's dot pattern is unambiguous and fully visible for the photogrammetric capture.",
   "L5_clinical_context": "Mandible, All-on-4 protocol: 5 implants (4.3x13 mm), multi-unit abutments torqued to 25 Ncm, carrying PIC-scan marker flags. Maxillary teeth with gold and metal crowns visible at top are the antagonist arch only.",
   "uncertainty": "The hand partially overlaps the left flag cluster, so it cannot be confirmed whether one or two flags are stacked there, nor the exact manipulation being performed (touch/verify vs. re-seat).",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0461",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2799.619,
   "phase_index": 8,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2804.579,
     "category": "technique",
     "statement": "I'm going to open up a little bit here."
    }
   ],
   "L1_phase_normalized": "pic_scan",
   "L1_phase_detailed": "Surgeon's single gloved hand presses/points at the anterior mandibular gingiva/tooth region while announcing he will widen the retraction; the posterior implant sites are obscured in shadow behind the hand.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "lower lip"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "presses on",
     "gingiva"
    ]
   ],
   "L4_reasoning": "This is the last frame of the batch, at the tail of the phase (position_in_phase 0.998); the surgeon states he will open the retraction further, likely to get better access/visibility for the remaining flag-removal and cap-seating steps that continue past this phase's end.",
   "L5_clinical_context": "End of the visible pic_scan window for this camera; whether all markers have been replaced with white caps by this point is not resolved within this batch.",
   "uncertainty": "The posterior mandibular implant sites are hidden in shadow behind the hand; it cannot be determined whether any markers, exposed abutments, or white caps are present there at this moment. A dark shape deep in the mouth may be a remaining marker but is too indistinct to annotate as an L2 entry.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0462",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2805.419,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2776.007,
     "category": "materials",
     "statement": "Open, open, removing flags and put white covers again, white caps.",
     "removed_by_outbound_edit": null,
     "snapped_to_cut_boundary": {
      "original_time_deid": 3143.56,
      "cut": 2,
      "joint_at_outbound_edit_sec": 2776.007,
      "transcript_segment": 194,
      "reason": "utterance starts inside removed window cut 2 but continues past the joint (transcript segment 194 survives clipped); time moved forward to the joint so it points at picture that exists"
     }
    },
    {
     "time": 2804.579,
     "category": "technique",
     "statement": "I'm going to open up a little bit here."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "post-implant-placement site check, removing PIC scan flag from anterior mandibular ridge before white cap placement, all-on-4 site",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "PIC scan marker",
     "confidence": "certain",
     "source": "both"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "PIC scan marker",
     "seated on",
     "multi-unit abutment"
    ],
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "The black flag with white dots is the PIC scan marker being removed before the white caps go back on, per the doctor's own narration heard just before this frame ('removing flags and put white covers again, white caps'); this is the digital-workflow marker referenced in case_facts as 'PIC scan'.",
   "L5_clinical_context": "Anterior mandibular ridge, all-on-4 site, sutured and closed after implant/abutment placement; maxillary teeth are the patient's own dentition (antagonist arch) with a gold crown visible mesially, not to be confused with the mandibular abutments.",
   "uncertainty": "One or more mandibular abutment sites still show bare metal (no cap) while the PIC scan marker is being lifted off another; cannot confirm from this single frame exactly how many of the 5 implant sites already have a cap seated.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0557",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2818.819,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2804.579,
     "category": "technique",
     "statement": "I'm going to open up a little bit here."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: OptraGate retractor in place, gloved fingers holding a small instrument near the floor of the mouth/frenulum.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "oral mucosa",
    "gingiva"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "The surgeon manipulates tissue/instrumentation near the floor of the mouth while continuing to expose the mandibular arch for the impending impression and bite registration steps.",
   "L5_clinical_context": "Clear visualization of the mandibular ridge and the multi-unit abutments is required before an accurate impression or bite registration record can be taken.",
   "uncertainty": "A small dark instrument tip is visible between the gloved fingers near the floor of the mouth; it cannot be identified with confidence (possibly a probe, forceps, or elevator) and is therefore not listed in L2 per the rule that unidentifiable objects go to uncertainty, not L2_other.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0470",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2852.419,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    },
    {
     "time": 2881.159,
     "category": "prosthetic_plan",
     "statement": "and everything for producing digital design and then printing the lower arch."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "row of white caps (3-4 visible) now seated across most anterior mandibular sites, ridge nearly ready for impression taking",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "Visual progress matches the doctor's narrated plan: caps are being seated across the arch so a full-arch impression capturing vertical dimension and bite can be taken for the digital lower-arch design.",
   "L5_clinical_context": "All-on-4 mandible, 5 implants total (case_facts); caps visible here are the white transfer/healing-type components, not the gold multi-unit abutments themselves which sit underneath.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0567",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2854.219,
   "phase_index": 9,
   "image_quality": "degraded",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    },
    {
     "time": 2881.159,
     "category": "prosthetic_plan",
     "statement": "and everything for producing digital design and then printing the lower arch."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: cap placement in progress across the arch - at least one abutment already carries a white cap while others remain bare.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "multi-unit abutment",
     "supports",
     "healing cap"
    ]
   ],
   "L4_reasoning": "Sequential capping of the mandibular abutments is underway directly preceding the surgeon's stated plan to record vertical dimension and bite registration for the digital design and printing of the lower arch.",
   "L5_clinical_context": "Sequential capping of the five Nobel Biocare multi-unit abutments (case_facts: 5 x 4.3x13 mm implants) is required before an accurate full-arch impression or scan can be taken.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Exact count of capped vs. bare abutments is difficult to determine precisely at this resolution.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0568",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2856.819,
   "phase_index": 9,
   "image_quality": "degraded",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: gloved hand pointing a thin instrument toward the tongue/frenulum area, obscuring the abutments.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "tongue"
    ]
   ],
   "L4_reasoning": "Surgeon continues manipulating the field immediately before verbally announcing the shift to impressions, vertical dimension, and bite registration.",
   "L5_clinical_context": "Consistent with the case's transition toward the digital design/printing workflow for the lower arch prosthesis.",
   "uncertainty": "Mandibular abutments and caps are obscured by the tongue and the gloved hand in this frame; the small instrument held is not clearly identifiable.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0471",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2856.819,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    },
    {
     "time": 2881.159,
     "category": "prosthetic_plan",
     "statement": "and everything for producing digital design and then printing the lower arch."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "gloved hand approaching mandibular ridge with a full row of white caps now seated across the arch",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "approaches",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Final check of the seated caps immediately before impression material/tray would be introduced, consistent with the stated plan of taking impressions for the digital lower-arch design.",
   "L5_clinical_context": "Anterior mandibular ridge, all-on-4; view essentially unchanged from the previous frame aside from the hand's position.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0472",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2864.619,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "full set of white caps seated across the mandibular ridge at the exact moment the doctor announces the impressions/vertical-dimension/bite-registration step -- milestone frame for this phase",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "This frame's timestamp (3233.6s) exactly matches the ground-truth milestone quote (delta_sec 0.0) marking the formal start of the impressions_and_bite phase: impressions, vertical dimension, and bite registration, ahead of digital design and printing of the lower arch.",
   "L5_clinical_context": "All-on-4 mandible, 5 x 4.3x13mm implants (case_facts); caps are the interim white components covering the multi-unit abutments prior to impression-tray placement.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0569",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2864.819,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: three multi-unit abutments now visible with white caps in place, clear view of the arch.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "blood",
    "saliva"
   ],
   "L3_triplets": [
    [
     "multi-unit abutment",
     "supports",
     "healing cap"
    ]
   ],
   "L4_reasoning": "This frame captures the moment the surgeon announces the transition to impressions, vertical dimension, and bite registration, with three of the mandibular abutments already fitted with white caps in preparation for the digital scan/impression.",
   "L5_clinical_context": "The stated workflow ('impressions and vertical dimensions, bite registration ... producing digital design and then printing the lower arch') corresponds to a digital All-on-4 restorative pathway: scan bodies/white caps on the multi-unit abutments enable a scan used to design and mill/print the definitive or interim prosthesis.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0570",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2868.219,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: same clear full-arch view moments later, three white-capped abutments visible.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "blood",
    "saliva"
   ],
   "L3_triplets": [
    [
     "multi-unit abutment",
     "supports",
     "healing cap"
    ]
   ],
   "L4_reasoning": "Stable continuation of the previous frame while the surgeon completes the statement about moving to impressions, vertical dimension, and bite registration.",
   "L5_clinical_context": "Same clinical context: white caps over the multi-unit abutments prepare the mandibular arch for the digital scan/impression feeding the printed lower-arch design.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0473",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2868.219,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "white caps seated across mandibular ridge, gloved hand holding a small unidentified metallic instrument near the site",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "OptraGate lip-and-cheek retractor",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Continuation of the impressions/bite-registration milestone moment; surgeon appears to be reaching for or holding a small instrument, likely in preparation for tray/material placement.",
   "L5_clinical_context": "Anterior mandibular ridge, all-on-4 site.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Additionally, a small shiny object held in the gloved fingers at the bottom of frame is too small/blurred to identify against the controlled vocabulary, so it is not listed in L2.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0571",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2870.219,
   "phase_index": 9,
   "image_quality": "degraded",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: gloved hand occludes most of the field; gold crown edge on the maxillary arch visible at top.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "maxillary teeth",
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [],
   "L4_reasoning": "Brief occlusion of the field by the gloved hand while the surgeon continues speaking about the impressions/bite registration/digital design workflow.",
   "L5_clinical_context": "Same phase context as neighbouring frames.",
   "uncertainty": "Frame is degraded and dominated by a close gloved hand; mandibular abutments/caps are not visible in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0572",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 2877.419,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2864.579,
     "category": "prosthetic_plan",
     "statement": "So, now I am going to make some impressions and vertical dimensions, bite registration"
    },
    {
     "time": 2881.159,
     "category": "prosthetic_plan",
     "statement": "and everything for producing digital design and then printing the lower arch."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Impressions/bite setup, mandibular arch: clear view, gloved finger pointing toward the capped abutments while the surgeon finishes describing the digital workflow.",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "multi-unit abutment",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "gingiva",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "points to",
     "mandibular alveolar ridge"
    ],
    [
     "multi-unit abutment",
     "supports",
     "healing cap"
    ]
   ],
   "L4_reasoning": "Surgeon indicates the capped abutments while completing the statement about the digital workflow (impressions, vertical dimension, bite registration, digital design, printing the lower arch).",
   "L5_clinical_context": "Consistent with preparing the mandibular arch for an accurate scan/impression to design the printed lower-arch prosthesis.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0474",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2895.819,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": 8,
   "in_keyframe_showcase": false,
   "L0_doctor_statements": [
    {
     "time": 2881.159,
     "category": "prosthetic_plan",
     "statement": "and everything for producing digital design and then printing the lower arch."
    },
    {
     "time": 2893.819,
     "category": "prosthetic_plan",
     "statement": "Dentures."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "white caps remain seated across mandibular ridge, idle view while doctor states the prosthetic plan ('dentures') for the printed lower arch",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "healing cap",
     "seated on",
     "multi-unit abutment"
    ]
   ],
   "L4_reasoning": "The doctor's short statement 'Dentures.' (repeated twice) confirms the prosthetic end-product being planned for after digital design -- a denture-type full-arch restoration for the mandible.",
   "L5_clinical_context": "All-on-4 mandible; the printed lower arch referenced here is the prosthesis that will attach to the multi-unit abutments currently protected by the white caps.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0479",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 2903.615,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 2904.816,
     "category": "observation",
     "statement": "So, let's see the size, like that, should be good."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "gloved hand visible at bottom of frame, mandibular ridge with white caps still seated, doctor checking the size/fit of a component",
   "L2_instruments": [
    {
     "name": "OptraGate lip-and-cheek retractor",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "healing cap",
     "confidence": "probable",
     "source": "visual",
     "identified_by": "cap_type_round3_2026-08-05"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "gauze",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "nasal oxygen cannula",
     "confidence": "probable",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "mandibular alveolar ridge",
    "mucoperiosteal flap",
    "gingiva",
    "maxillary teeth",
    "dental crown (existing restoration)",
    "lower lip",
    "upper lip",
    "blood"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "positions near",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "The doctor is assessing the size/fit of a tray or prosthetic component against the arch, immediately preceding the extraoral lip-retraction views and the bite-check sequence that follows.",
   "L5_clinical_context": "Anterior mandibular ridge, all-on-4 site; the object being sized is not clearly visible in this particular frame.",
   "uncertainty": "Cap type resolved 2026-08-05 (surgeon, round 3, cap_type_by_position_v2): all five implant positions carry the same component, a Nobel Biocare multi-unit abutment healing cap, and it was not changed during the operation. The three L2 names this corpus used for it (healing cap / white scanning cap / comfort cap) were an annotator naming artefact and are unified to 'healing cap'; the OR narration at 30:36 still distinguishes sub-types and is kept verbatim in L0, but the surgeon's later frame-based answer is authoritative for the label. Cannot confirm which specific component (tray, trial denture, or bite registration material) the doctor is referring to as being sized in this frame.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "sony_lateral_0498",
   "camera": "sony_lateral",
   "camera_role": "lateral",
   "video_timestamp_sec": 3031.224,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 3017.324,
     "category": "prosthetic_plan",
     "statement": "I'm going to put it in the oven."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "gloved hands retracting the lip and inserting the trial denture against the mandibular arch, a further try-in/bite cycle",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "trial denture (try-in)",
     "confidence": "probable",
     "source": "visual"
    },
    {
     "name": "surgical drape",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "lower lip",
    "chin"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "lower lip"
    ],
    [
     "trial denture (try-in)",
     "inserted into",
     "mandibular alveolar ridge"
    ]
   ],
   "L4_reasoning": "Another insertion of the same ridged trial denture into the mandibular arch, part of the repeated try-in/bite verification cycle running through this batch.",
   "L5_clinical_context": "Continued fitting of the trial denture supports final confirmation of vertical dimension and occlusion before the printed mandibular arch is produced.",
   "uncertainty": "The maxillary antagonist arch is not in frame here, so the bite relationship cannot be cross-checked in this specific image.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0598",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 3036.024,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [
    {
     "time": 3017.324,
     "category": "materials",
     "statement": "I'm going to put it in the oven."
    }
   ],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "impressions and bite registration, gloved fingers adjusting the bite-registration-coated trial denture near the maxillary crown, background dark/out of focus",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "trial denture (try-in)",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "bite registration material",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "dental crown (existing restoration)"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "positions",
     "trial denture (try-in)"
    ]
   ],
   "L4_reasoning": "Continued positioning of the bite-registration-coated trial denture against the upper arch, with a visible thread of excess material at the corner of the mouth.",
   "L5_clinical_context": "Same bite registration step; the crown glint confirms the maxillary antagonist tooth is again the reference point.",
   "uncertainty": "Background is dark and out of focus; limited additional anatomy is identifiable beyond the crown and denture area.",
   "no_surgical_field": false
  },
  {
   "keyframe_id": "lumix_overhead_0622",
   "camera": "lumix_overhead",
   "camera_role": "overhead",
   "video_timestamp_sec": 3271.424,
   "phase_index": 9,
   "image_quality": "ok",
   "in_lerobot_episode": null,
   "in_keyframe_showcase": true,
   "L0_doctor_statements": [],
   "L1_phase_normalized": "impressions_and_bite",
   "L1_phase_detailed": "Similar wide-open mouth view, tongue visible, gloved hand retracting the cheek/lip, a dark tooth/crown shape at the top-left corner.",
   "L2_instruments": [
    {
     "name": "gloved hand",
     "confidence": "certain",
     "source": "visual"
    },
    {
     "name": "suture thread",
     "confidence": "certain",
     "source": "visual"
    }
   ],
   "L2_other": [],
   "anatomy_visible": [
    "tongue",
    "lower lip",
    "maxillary teeth",
    "chin"
   ],
   "L3_triplets": [
    [
     "gloved hand",
     "retracts",
     "lower lip"
    ]
   ],
   "L4_reasoning": "Continuation of inspection/adjustment at the arch, similar to the previous frame, with cheek retraction for visibility.",
   "L5_clinical_context": "Not assessable beyond general retraction and confirmation of the maxillary tooth landmark.",
   "uncertainty": "The dark shape at top-left is probably the maxillary tooth/crown seen throughout the batch, but is not fully certain due to shadow; nearest speech ('Thank you.') is flagged and excluded.",
   "no_surgical_field": false
  }
 ]
}