1
|
Martinho FC, Rollor C, Westbrook K, Aldahmash SA, Fay GG, Rivera E, Parsa A, Price JB, Tordik PA. A Cadaver-based comparison of Sleeve-Guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections. J Endod 2023:S0099-2399(23)00288-1. [PMID: 37263496 DOI: 10.1016/j.joen.2023.05.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/20/2023] [Accepted: 05/22/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER). METHODS Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). CBCT scans were taken pre- and postoperatively. The osteotomy and RER were planned virtually in the preoperative CBCT scan and guided using 3D-printed surgical guides in the FG sCAEMS and 3D-dynamic navigation system in the dCAEMS. The 2D and 3D deviations and angular deflection (AD) were calculated. The osteotomy volume, resected root length, and resection angle were measured. The osteotomy and RER time and the number of procedural mishaps were recorded. RESULTS FG sCAEMS was as accurate as dCAEMS, with no difference in the 2D and 3D deviation values or AD (p >.05). The osteotomy and RER time were shortened using FG sCAEMS (p <.05). The FG sCAEMS showed a greater number of incomplete RERs than dCAEMS. Osteotomy volume, RER angle, and root length resected were similar in both groups (p >.05). FG sCAEMS and dCAEMS were feasible for osteotomy and RER. CONCLUSIONS Within the limitations of this cadaver-based study, FG sCAEMS was as accurate as dCAEMS. Both FG sCAEMS and dCAEMS were time-efficient for osteotomy and RER, but FG sCAEMS required less surgical time.
Collapse
Affiliation(s)
- Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland.
| | - Corey Rollor
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Kyle Westbrook
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Sara A Aldahmash
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Guadalupe G Fay
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Elias Rivera
- Division of Prosthodontics - Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| | - Azin Parsa
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry - Baltimore - Maryland
| |
Collapse
|
2
|
Westbrook K, Rollor C, Aldahmash SA, Fay GG, Rivera E, Price JB, Griffin I, Tordik PA, Martinho FC. Comparison of a Novel Static Computer-aided Surgical and Freehand Techniques for Osteotomy and Root-end Resection. J Endod 2023; 49:528-535.e1. [PMID: 36828284 DOI: 10.1016/j.joen.2023.02.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 01/26/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023]
Abstract
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.
Collapse
Affiliation(s)
- Kyle Westbrook
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Corey Rollor
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Sara A Aldahmash
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland; King Abdullah Bin Abdulaziz University Hospital, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Guadalupe G Fay
- Division of Prosthodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Elias Rivera
- Division of Prosthodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland; Private Practice, Stafford, Virginia
| | - Jeffery B Price
- Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina Griffin
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Patricia A Tordik
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Frederico C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
| |
Collapse
|