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Qin L, Chen C, Zhang R, Wang Z, Li F, Meng L. Evaluation of a Novel Drilling Approach for Dynamic Navigation-Aided Endodontic Microsurgery: A Surgical Simulation Comparison Study. J Endod 2024; 50:989-996. [PMID: 38556075 DOI: 10.1016/j.joen.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/02/2024]
Abstract
INTRODUCTION This study investigated the feasibility of a novel drilling approach that integrates a pilot trephine into dynamic navigation (DN) for guided osteotomy and root-end resection (RER) with unimanual operation in endodontic microsurgery. METHODS Two operators with varying levels of DN experience performed guided osteotomy and RER using 2 unimanual drilling methods with DN-aided operation on 3-dimensional printed jaw models. Method 1 (M1) involved drilling with a conventional trephine. Method 2 (M2) involved drilling with a pilot trephine, followed by drilling with a conventional trephine. Accuracy, time, and safety of M1 and M2 were compared. Accuracy measurements included platform deviation (PD), end deviation (ED), angular deviation (AD), resection length deviation (RLD), and resection bevel angle (RBA). Additional parameters included osteotomy and RER time (OT) and bur slippage number (BSN). Statistical analyses were conducted using a 2-sample t-test or Mann-Whitney U test, with the significance level set at .05. RESULTS The PD, AD, RBA, and BSN in the M2 group were significantly less than in the M1 group (P < .05). For M1, the novice operator (NO) exhibited significantly higher values of PD, ED, OT, and BSN than the experienced operator (EO) (P < .05). For M2, the NO exhibited significantly higher value of ED only (P < .05), and drilling depth >7 mm was significantly associated with a longer OT (P < .05). CONCLUSION In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided endodontic microsurgery.
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Affiliation(s)
- Li Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Chen Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zan Wang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fangzhe Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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La Rosa GRM, Peditto M, Venticinque A, Marcianò A, Bianchi A, Pedullà E. Advancements in guided surgical endodontics: A scoping review of case report and case series and research implications. AUST ENDOD J 2024. [PMID: 38887152 DOI: 10.1111/aej.12865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/15/2024] [Accepted: 06/08/2024] [Indexed: 06/20/2024]
Abstract
This scoping review examined current case series and reports on guided surgical endodontic applications in order to provide a critical platform for future research. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines were followed. A search on PubMed and Scopus yielded 611 articles, with 17 case reports and 1 series meeting inclusion criteria. Overall, guided surgery addressed anatomical complexities, with 15 articles employing static protocols and 3 dynamic. Results showed minimal iatrogenic errors and reduced chair time, with no postoperative issues reported. Within the cases described, guided endodontic surgery exhibited satisfactory results in management of anatomical complex cases. Cost-effectiveness, the need for adequate follow-up, procedure's reproducibility and accuracy, and objective measurement of the reduction in operative times and iatrogenic errors are some of the limitations in the current reports that need to be considered for planning of future experimental and cohort studies.
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Affiliation(s)
- Giusy Rita Maria La Rosa
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Matteo Peditto
- Postgraduate School of Oral Surgery, Department of Biomedical, Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Andrea Venticinque
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Antonia Marcianò
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Alberto Bianchi
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
| | - Eugenio Pedullà
- Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy
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Chen C, Qin L, Zhang R, Meng L. Comparison of Accuracy and Operation Time in Robotic, Dynamic, and Static-Assisted Endodontic Microsurgery: An In Vitro Study. J Endod 2024:S0099-2399(24)00342-X. [PMID: 38838934 DOI: 10.1016/j.joen.2024.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/25/2024] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
INTRODUCTION This study aimed to compare the accuracy and operation time (OT) of robotic-assisted endodontic microsurgery (RA-EMS), dynamic navigation-guided (DN-guided) EMS, and static navigation-guided (SN-guided) EMS. METHODS Seventy-two teeth from three sets of standardized jaw models (TrueTooth, DELendo, Santa Barbara, CA) randomly assigned into 3 groups underwent osteotomy and root-end resection. Preoperative plans and postoperative cone-beam computed tomography images were imported into an accuracy analysis system and aligned based on the anatomical structures to assess accuracy. The OT was recorded from the moment the foot pedal was pressed down until the bur reached the target depth. Statistical analyses were conducted using Kruskal-Wallis and Scheirer-Ray-Hare tests, with significance set at P < .05. RESULTS RA-EMS exhibited significantly higher accuracy than DN- and SN-guided EMS in terms of platform, angular, and resection angular deviations (P < .05). Additionally, RA-EMS exhibited significantly higher accuracy than DN-guided EMS in resection length deviation (P < .05). Significant differences were also observed in OTs between the 3 approaches, with SN-guided EMS showing the shortest OT, followed by RA-EMS and DN-guided EMS. Differences in jaw types within the DN-guided EMS group were observed in terms of angular deviation (P < .05). CONCLUSIONS All 3 treatment approaches demonstrated acceptable clinical accuracy and OT. RA-EMS exhibited superior accuracy, suggesting its potential application prospects in endodontics. Further high-quality clinical studies are warranted.
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Affiliation(s)
- Chen Chen
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
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Wei X, Du Y, Zhou X, Yue L, Yu Q, Hou B, Chen Z, Liang J, Chen W, Qiu L, Huang X, Meng L, Huang D, Wang X, Tian Y, Tang Z, Zhang Q, Miao L, Zhao J, Yang D, Yang J, Ling J. Expert consensus on digital guided therapy for endodontic diseases. Int J Oral Sci 2023; 15:54. [PMID: 38052782 DOI: 10.1038/s41368-023-00261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/12/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023] Open
Abstract
Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
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Affiliation(s)
- Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yu Du
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xiangya Huang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yu Tian
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Zisheng Tang
- Department of Stomatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Leiying Miao
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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