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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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