A Comparative Analysis of the Piezoelectric Ultrasonic Appliance and Trephine Bur for Apical Location: An In Vitro Study

Is Augmented Reality Technology Effective in Locating the Apex of Teeth Undergoing Apicoectomy Procedures?

This study seeks to assess the accuracy of apical location using an augmented reality (AR) device with a free-hand method. Sixty (60) osteotomy site preparations were randomly assigned to one of two study groups: A. AR device (AR) (n = 30), and B. conventional free-hand method (FHM) (n = 30). Preoperative CBCT scans and intraoral scans were taken and uploaded to specialized implant-planning software to virtually plan preparations for the apical location osteotomy sites. The planning software was then used to automatically segment the teeth in each experimental model for their complete visualization using the AR device. A CBCT scan was carried out postoperatively after conducting the apical location procedures. The subsequent datasets were imported into therapeutic software to analyze the coronal, apical, and angular deviations. The Mann-Whitney non-parametric test was used. There were no statistically significant differences identified at the coronal (p = 0.1335), apical (p = 0.2401), and angular deviations (p = 0.4849) between the AR and FHM study groups. The augmented reality technique did not show a statistically significant accuracy of osteotomies for apical location when compared with the conventional free-hand method.

Comparison of a Novel Static Computer-aided Surgical and Freehand Techniques for Osteotomy and Root-end Resection

INTRODUCTION

This study compared the accuracy and efficiency of a novel static computer-aided surgical technique using a 3-dimensional (3D)-printed surgical guide (3D-SG) with a fully guided drill protocol (3D-SG FG) to the freehand (FH) osteotomy and root-end resection (RER).

METHODS

Forty-six roots from 2 cadaver heads were divided into 2 groups: 3D-SG FG (n = 23) and FH (n = 23). Cone-beam computed tomographic scans were taken preoperatively and postoperatively. The endodontic microsurgery was planned in Blue Sky Bio software, and the 3D-SG was designed and 3D printed. The osteotomy and RER were conducted using a guided twist drill diameter of 2 mm and an ascending tapered drill with diameters of 2.8/3.2, 3.2/3.6, 3.8/4.2, and 4.2 mm with respective guided drill guides. Two-dimensional and three-dimensional virtual deviations and angular deflection were calculated. Linear osteotomy measures and root resection angle were obtained. The osteotomy and RER time and the number of mishaps were recorded.

RESULTS

Two-dimensional and three-dimensional accuracy deviations and angular deflection were lower in the 3D-SG FG protocol than in the FH technique (P < .05). The height, length, and depth of the osteotomy and root resection angle were less in the 3D-SG FG protocol than in the FH technique (P < .05). The osteotomy and RER time with the 3D-SG FG protocol were less than the FH method (P < .05).

CONCLUSIONS

Within the limitations of this cadaver-based study using denuded maxillary and mandibular jaws, 3D-SG FG protocol showed higher accuracy than FH osteotomy and RER. Moreover, the 3D-SG FG drill protocol significantly reduced the surgical time.