1
|
Rajnics Z, Mandel I, Nagy Á, Turzó K, Mühl A, Marada G. Effect of different parameters utilized for image guided endodontic root canal preparation on temperature changes: an in vitro study. BMC Oral Health 2024; 24:76. [PMID: 38218822 PMCID: PMC10787981 DOI: 10.1186/s12903-023-03799-x] [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: 10/05/2023] [Accepted: 12/18/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Navigated endodontics is a cutting-edge technology becoming increasingly more accessible for dental practitioners. Therefore, it is necessary to clarify the ideal technical parameters of this procedure to prevent collateral damage of the surrounding tissues. There is a limited number of studies available in published scientific literature referencing the possible collateral thermal damage due to high-speed rotary instruments used in guided endodontic drilling. The aim of our study was to investigate the different drilling parameters and their effect upon the temperature elevations measured on the outer surface of teeth during guided endodontic drilling. METHODS In our in vitro study, 72 teeth with presumably narrow root canals were prepared using a guided endodontic approach through a 3D-printed guide. Teeth were randomly allocated into six different test groups consisting of 12 teeth each, of which, four parameters affecting temperature change were investigated: (a) access cavity preparation prior to endodontic drilling, (b) drill speed, (c) cooling, and (d) cooling fluid temperature. Temperature changes were recorded using a contact thermocouple electrode connected to a digital thermometer. RESULTS The highest temperature elevations (14.62 °C ± 0.60 at 800 rpm and 13.76 °C ± 1.24 at 1000 rpm) were recorded in the groups in which drilling was performed without prior access cavity preparation nor without a significant difference between the different drill speeds (p = 0.243). Access cavity preparation significantly decreased temperature elevations (p < 0.01) while drilling at 800 rpm (8.90 °C ± 0.50) produced significantly less heating of the root surface (p < 0.05) than drilling at 1000 rpm (10.09 °C ± 1.32). Cooling significantly decreased (p < 0.01) temperature elevations at a drill speed of 1000 rpm, and cooling liquid temperatures of 4-6 °C proved significantly (p < 0.01) more beneficial in decreasing temperature elevations (1.60 °C ± 1.17) than when compared with room temperature (21 °C) liquids (4.01 °C ± 0.22). CONCLUSIONS Based on the results of our study, guided endodontic drilling at drill speeds not exceeding 1000 rpm following access cavity preparation, with constant cooling using a fluid cooler than room temperature, provides the best results in avoiding collateral thermal damage during navigated endodontic drilling of root canals.
Collapse
Affiliation(s)
- Zsolt Rajnics
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary
| | - Iván Mandel
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary
| | - Ákos Nagy
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary
| | - Kinga Turzó
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary
| | - Attila Mühl
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary.
| | - Gyula Marada
- Dental School, Medical Faculty, University of Pécs, Tüzér u. 1, Pécs, H-7623, Hungary
| |
Collapse
|
2
|
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.
Collapse
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.
| |
Collapse
|
3
|
Elhakim A, Hwang J, Kim S, Kim E, Kang S. Three-dimensional accuracy of endodontic access preparations using novel nonrestrictive static guides: A laboratory study. AUST ENDOD J 2023; 49:631-640. [PMID: 37697890 DOI: 10.1111/aej.12792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 06/22/2023] [Accepted: 08/13/2023] [Indexed: 09/13/2023]
Abstract
This study compared the accuracy of traditional endodontic access to conservative access cavities prepared with or without novel nonrestrictive endodontic access guides by operators with different levels of clinical experience without visual aids, using a three-dimensional volumetric accuracy analysis method. The accuracy of the preparations was analysed using a novel 3D volumetric analysis by calculating the intersection and volume of the actual cavities to the planned model cavities. The experienced operator significantly outperformed the inexperienced operator in the free hand groups, while accuracy of conservative access cavities prepared using the novel guides were comparable and significantly higher than the other groups (p < 0.05). The results demonstrated clinical experience enhanced endodontic preparations accuracy and that nonrestrictive guides achieve accurate conservative access cavities which are independent of the operator skill level. Additionally, the three-dimensional volumetric analysis is a consistent and objective method to judge the accuracy of guided endodontic techniques.
Collapse
Affiliation(s)
- Ahmed Elhakim
- Department of Endodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Junghwan Hwang
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sunil Kim
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Euiseong Kim
- Department of Conservative Dentistry and Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sumi Kang
- Department of Dental Education, College of Dentistry, Yonsei University, Seoul, Korea
| |
Collapse
|
4
|
Choi S, Choi J, Peters OA, Peters CI. Design of an interactive system for access cavity assessment: A novel feedback tool for preclinical endodontics. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2023; 27:1031-1039. [PMID: 36655941 DOI: 10.1111/eje.12895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/04/2022] [Accepted: 01/15/2023] [Indexed: 06/17/2023]
Abstract
INTRODUCTION A software program was developed to provide visual, guided feedback to students for access cavity preparations in preclinical learning. The specific aim of the study was to investigate students' overall experiences with the new learning method and compare their experiences with traditional teaching. MATERIALS AND METHODS A workflow based on freely available software was designed to interactively register three-dimensional models of molars with access cavities, and to metrically compare these to instructor-prepared standard cavities. Third-year students practicing molar endodontics access cavity preparation in the preclinical course were then surveyed. A total of 44/79 students completed self-administered questionnaires prior and after the use of the feedback software to gauge their learning experience. RESULTS The results of the post-training questionnaire illustrated that all surveyed students agreed/strongly agreed that the software assisted their learning in access cavity preparation. In addition, 86 and 89%, respectively, of students agreed that the use of the software improved their skills of access cavity preparation and felt more confident about their access cavity preparation skills after using the software package, 3D Dental Align. DISCUSSION The presented software solution permitted setting and comparing access cavity preparations by students against a standard access prepared by an instructor. The process of data acquisition and registration was fast and straightforward. Student feedback was very positive and suggested the integration of this type of experiential learning into the preclinical curriculum. CONCLUSION This feasibility study demonstrated the utility of the new technology to assist dental students' access cavity preparation learning.
Collapse
Affiliation(s)
- Seongwon Choi
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Jiwon Choi
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ove A Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Christine I Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| |
Collapse
|
5
|
Pires CRF, Souza-Gabriel AE, Pelozo LL, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Guided endodontics of calcified canals: The drilling path of rotary systems and intracanal dentin wear. AUST ENDOD J 2023; 49 Suppl 1:64-70. [PMID: 36106713 DOI: 10.1111/aej.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/03/2022] [Indexed: 11/26/2022]
Abstract
This study evaluated the drilling path (mm) and the dentin wear (mm3 ) of two instruments used during guided endodontic access. Twenty mandibular incisors with calcified canals were selected using cone-beam computed tomography (CBCT) and fixed in articulated models. Preoperative CBCT scans were performed in combination with intraoral scanning, and the images were reconstructed in the Blue Sky Bio software for access planning and printing the guides. The access cavity was drilled with 1.0-mm-diameter bur (DSP) and 0.8-mm-diameter bur (Munce). Postoperative CBCT was performed, and the images obtained preoperative and postoperative were superimposed for the analyses. Data were analysed by a t-test and linear regression (α = 0.05). No difference was found in the drilling path (p = 0.422). However, the Munce bur had higher dentin wear than the DSP bur (p = 0.011). A positive linear correlation (R2 = 0.859) was found between the factors.
Collapse
Affiliation(s)
| | | | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio Miranda Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Gariba Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| |
Collapse
|
6
|
Ambu E, Gori B, Marruganti C, Malvicini G, Bordone A, Giberti L, Grandini S, Gaeta C. Influence of Calcified Canals Localization on the Accuracy of Guided Endodontic Therapy: A Case Series Study. Dent J (Basel) 2023; 11:183. [PMID: 37623279 PMCID: PMC10453682 DOI: 10.3390/dj11080183] [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: 02/19/2023] [Revised: 03/05/2023] [Accepted: 07/26/2023] [Indexed: 08/26/2023] Open
Abstract
This study aimed to evaluate the precision of the guided endodontic technique applied to calcified canals in anterior teeth in relation to demographic and dental variables. The present observational study was conducted during the period 2020-2021. The patients were consecutive referrals at the Department of Endodontics and Conservative Dentistry of the University Hospital of Siena. The guided endodontics protocol was applied using 0.75 mm diameter burs for the lower teeth and 0.90 mm for the upper teeth. The inclusion criteria were as follows: (i) teeth with pulp canal obliteration (PCO) associated with a periapical lesion (periapical index (PAI) ≥ 2); (ii) teeth with PCO that require the placement of a root canal post for the execution of a prosthetic treatment; (iii) teeth in which surgical treatment was not justified. Socio-demographic characteristics of the patients were recorded and related to the drill path accuracy through the guide in the calcified endodontic canal, evaluated through a radiographic analysis, and classified as optimal (in the center of the root canal) and acceptable (deviated peripherally/tangentially). A logistic regression model was built to predict the factors that influence the poor precision of the technique. Seventeen patients (mean age 48 years) with eighteen calcified single-rooted teeth were enrolled. All teeth were associated with periapical lesions with PAI scores from 2 to 5 (mean PAI: 3.055). From the model, it is evident that the presence of a calcification affecting the apical area of the root increases the probability of being off-center with the bur by about 15 times. In addition, a previous attempt at endodontic treatment and the position in the lower arch increases the probability of non-centrality of the drill, although in a non-statistically significant way. In any of the analyzed cases, the guided endodontic technique applied to PCO did not determine the presence of iatrogenic errors, such as perforations. However, the apical localization of the obliteration increases the probability of being off-center with the drill during the instrumentation phase by about 15 times.
Collapse
Affiliation(s)
- Emanuele Ambu
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| | - Benedetta Gori
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| | - Crystal Marruganti
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| | - Giulia Malvicini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| | | | | | - Simone Grandini
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| | - Carlo Gaeta
- Unit of Endodontics and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, 53100 Siena, Italy (G.M.)
| |
Collapse
|
7
|
Torres A, Dierickx M, Coucke W, Pedano MS, Lambrechts P, Jacobs R. Ex-vivo and in-vivo validation of a novel measuring protocol for guided endodontics. J Dent 2023:104566. [PMID: 37263407 DOI: 10.1016/j.jdent.2023.104566] [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: 10/21/2022] [Revised: 05/23/2023] [Accepted: 05/27/2023] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES To (1) validate the use of a post-operative intraoral scan (IOS) versus Cone Beam Computed Tomography (CBCT), gold standard, on its ability to measure the accuracy of guided endodontics, and (2) present clinical data on the accuracy of guided endodontics. METHODS Four models, including 10 extracted teeth each, were created. Forty guided access cavities were planned on dentin to simulate pulp canal obliteration (PCO). Two operators performed guided access cavities. A post-operative CBCT and IOS were acquired. The deviation coronally, apically, and angular deviation was measured with CBCT and IOS. Clinical accuracy was measured using an IOS acquired immediately after drilling the access cavity with the aid of a guide. Data analysis was performed using multiway Anova and corrected for simultaneous hypothesis testing according to Tukey. P ≤ 0.05 was considered statistically significant. Descriptive statistics on the clinical accuracy of guided endodontics were performed. RESULTS Thirty-eight cavities were assessed with a mean length of 13.8 mm. No statistical difference between operators and methods was found for all parameters (P > 0.05). Thirty-three patients were treated with guided endodontics and measured using an IOS. Results show an average coronal, apical, and angular deviation of 0.2 mm, 0.45 mm, and 1.91° respectively. The average length of the access cavities was 12.5 mm. CONCLUSIONS An IOS can be used to measure the accuracy of guided endodontics. Clinical data showed high accuracy of guided endodontics with a mean apical deviation smaller than 0.5 mm and a mean angular deviation of less than 2°. CLINICAL SIGNIFICANCE The use of an IOS does not involve additional radiation exposure. A safety margin of at least 1 mm around the planned trajectory should be respected when planning the case to minimize the possibility of root perforation.
Collapse
Affiliation(s)
- A Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - M Dierickx
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - W Coucke
- Certified Freelance Statistician, Heverlee, Belgium.
| | - M S Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - P Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - R Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, and Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
8
|
Singh S. From the Desk of the Editor: Guided Endodontics - A Paradigm Step Forward into the Future. J Conserv Dent 2023; 26:247-248. [PMID: 37398851 PMCID: PMC10309134 DOI: 10.4103/jcd.jcd_291_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 07/04/2023] Open
Affiliation(s)
- Shishir Singh
- Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India
| |
Collapse
|
9
|
Torres A, Dierickx M, Coucke W, Pedano MS, Lambrechts P, Jacobs R. In vitro study on the accuracy of sleeveless guided endodontics and treatment of a complex upper lateral incisor. J Dent 2023; 131:104466. [PMID: 36804580 DOI: 10.1016/j.jdent.2023.104466] [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: 11/18/2022] [Revised: 01/31/2023] [Accepted: 02/16/2023] [Indexed: 02/21/2023] Open
Abstract
PURPOSE The present study aims to assess the accuracy of sleeveless guided endodontics for root canal treatment of severe pulp canal obliteration (PCO) in 3D printed jaws. Additionally, the treatment of a complex lateral incisor is presented to illustrate the use of sleeveless guides in a clinical situation. METHODS Two cone-beam computed tomography (CBCT) volumes of an upper and lower jaw were selected to design 3D printed models with PCO. Virtual planning of the access cavities was performed from right to left second premolar. Then, the models were mounted into a phantom head to simulate an actual patient. Two operators with different levels of experience in endodontics performed guided access cavities. The handpiece was guided by guiding rails placed against each other on the sides of the tooth. A post-operative CBCT scan was taken for analysis. RESULTS Eighty-eight guided access cavities (44 per operator) were drilled on eight 3D printed models. The mean length of the access cavities was 15.3 mm, with a mean coronal and apical deviation of 0.5 mm and 0.7 mm respectively. The mean angular deviation was 1.5°. No statistically significant difference was found between operators for the three measured parameters. CONCLUSIONS This study demonstrates, within its limitations, that sleveless guides represent an accurate method for guided endodontic treatment. No statistically significant difference between operators was found when using the guide. CLINICAL SIGNIFICANCE This method offers a valuable alternative to conventional endodontic guides with similar accuracy results.
Collapse
Affiliation(s)
- A Torres
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - M Dierickx
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - W Coucke
- Certified Freelance Statistician, Heverlee, Belgium.
| | - M S Pedano
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - P Lambrechts
- Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
| | - R Jacobs
- OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.
| |
Collapse
|
10
|
Mo S, Xu Y, Zhang L, Cao Y, Zhou Y, Xu X. Accuracy of a 3D printed sleeveless guide system used for fiber post removal: An in vitro study. J Dent 2023; 128:104367. [PMID: 36402258 DOI: 10.1016/j.jdent.2022.104367] [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: 08/21/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The removal of fiber post is often a challenging task. A 3D printed assembled sleeveless system that guides the head of the handpiece instead of the drill was developed to address this issue. This study aimed to evaluate the accuracy of this novel guide system using an in vitro approach. METHODS A standard maxillary typodont was digitized. The right first molar, the right central incisor, the left first premolar, and the left second molar in the digitized dentition were virtually crown-amputated. Four cylinders (diameter: 6 mm, height: 12 mm) were positioned along the directions of the main roots of these teeth to establish the virtual test model. Ten copies of the test model were printed using light-polymerizing resin. Four assembled sleeveless guide systems targeting the cylindrical axes were designed and printed using titanium alloy. One senior prosthodontist performed the drilling task targeting each cylindrical axis aided by the guide system or freehand (20 teeth each). The drilled models were scanned. The coordinates of the centers of all perforations and circular bases on the coronal and apical surfaces were obtained. The linear and angular deviations between the actual drilling path and the cylindrical axis for each tooth were calculated and analyzed. RESULTS The guided group exhibited significantly smaller linear and angular deviations than the freehand group (coronal linear deviation: 0.19 ± 0.09 mm vs. 0.35 ± 0.18 mm, p = 0.0012; apical linear deviation: 0.54 ± 0.19 mm vs. 1.71 ± 0.51 mm, p < 0.001; angular deviation: 2.67 ± 1.07° vs. 8.48 ± 2.86°, p < 0.001). CONCLUSION The accuracy of the 3D printed assembled sleeveless guide system used for fiber post removal is superior to that of the freehand method within the limits of an in vitro design. CLINICAL SIGNIFICANCE For the removal of fiber posts, the present 3D printed sleeveless guide system can provide better accuracy that the conventional freehand method. This may justify the diffusion of the guided technique for fiber post removal.
Collapse
Affiliation(s)
- Siyi Mo
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Yongwei Xu
- Department of dentistry, Peking University People's Hospital, Xizhimen South Street 11, Beijing 100044, China
| | - Lei Zhang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Ye Cao
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China
| | - Xiaoxiang Xu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China.
| |
Collapse
|
11
|
Kulinkovych-Levchuk K, Pecci-Lloret MP, Castelo-Baz P, Pecci-Lloret MR, Oñate-Sánchez RE. Guided Endodontics: A Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13900. [PMID: 36360780 PMCID: PMC9657991 DOI: 10.3390/ijerph192113900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/18/2022] [Accepted: 10/22/2022] [Indexed: 06/16/2023]
Abstract
The main objective of this paper is to perform an updated literature review of guided endodontics based on the available up-to-date scientific literature to identify and describe the technique, its benefits, and its limitations. Four electronic databases (PubMed, Scopus, Science Direct, and Web of Science) were used to perform a literature search from 1 January 2017 to 13 May 2022. After discarding duplicates, out of 1047 results, a total of 29 articles were eligible for review. Guided endodontics is a novel technique that is currently evolving. It is applied in multiple treatments, especially in accessing and locating root canals in teeth with pulp canal obliteration, microsurgical endodontics, and removing glass fiber posts in endodontic retreatments. In addition, it is independent of an operator's experience, requires less treatment time for the patient, and is more accurate and safer than conventional endodontics.
Collapse
Affiliation(s)
- Kateryna Kulinkovych-Levchuk
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - María Pilar Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - Pablo Castelo-Baz
- Unit of Dental Pathology and Therapeutics II, School of Medicine and Dentistry, University of Santiago de Compostela, 15705 Santiago de Compostela, Spain
| | - Miguel Ramón Pecci-Lloret
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| | - Ricardo E Oñate-Sánchez
- Gerodontology and Special Care Dentistry Unit, Faculty of Medicine, IMIB-Arrixaca, Morales Meseguer Hospital, University of Murcia, 30008 Murcia, Spain
| |
Collapse
|