Department of Periodontology, Endodontology and Cariology, University Centre for Dental Medicine, University of Basel, Basel, Switzerland.
Department of Operative Dentistry and Periodontology, University of Würzburg, Würzburg, Germany.
J Endod. 2019 Mar;45(3):327-331. doi: 10.1016/j.joen.2018.11.006.
The aim of this in vitro study was to compare endodontic access cavities in teeth with calcified root canals prepared with the conventional technique and a guided endodontics approach regarding the detection of root canals, substance loss, and treatment duration.
Six identical sets of upper and lower jaw models were produced with 3-dimensional-printed incisors that had simulated calcified root canals. Splints for guided access preparations were fabricated based on 3-dimensional surface scans and cone-beam computed tomographic data sets. Under simulated clinical conditions, 3 operators with different levels of experience prepared access cavities on each front tooth with the conventional technique and guided endodontics (8 teeth per technique and operator). Access cavities were volumetrically assessed on postoperative cone-beam computed tomographic scans. Statistical significance was tested by examining the overlap of 95% confidence intervals (CIs).
Canal location was successful in 10 of 24 cases (41.7%) using the conventional technique and 22 of 24 cases (91.7%) with the guided approach. The mean substance loss of the conventional access and the guided access was 49.9 mm (95% CI, 42.2-57.6 mm) and 9.8 mm (95% CI, 6.8-12.9 mm), respectively. The treatment lasted 21.8 minutes (95% CI, 15.9-27.7 minutes) for the conventional technique and 11.3 minutes (95% CI, 6.7-15.9 minutes) for guided endodontics. The success of the guided approach was not influenced by the experience of the operator.
Guided endodontics allows a more predictable and expeditious location and negotiation of calcified root canals with significantly less substance loss.
本体外研究的目的是比较使用传统技术和引导式牙髓学方法制备有钙化根管的牙齿的牙髓腔入口，以评估根管探测、材料损耗和治疗时间。
使用 3D 打印的具有模拟钙化根管的切牙制作了 6 套相同的上下颌模型。根据 3D 表面扫描和锥形束 CT 数据集，制作了用于引导式预备的夹板。在模拟临床条件下，3 位经验水平不同的操作人员使用传统技术和引导式牙髓学（每种技术和操作人员各 8 颗牙）在上前牙上制备了牙髓腔入口。在术后锥形束 CT 扫描上对牙髓腔入口进行体积评估。通过检查 95%置信区间（CI）的重叠来检验统计学意义。
使用传统技术成功定位根管的有 10 例（41.7%），使用引导方法的有 22 例（91.7%）。传统入口和引导入口的平均材料损耗分别为 49.9mm（95%CI，42.2-57.6mm）和 9.8mm（95%CI，6.8-12.9mm）。传统技术的治疗时间为 21.8 分钟（95%CI，15.9-27.7 分钟），而引导牙髓学的治疗时间为 11.3 分钟（95%CI，6.7-15.9 分钟）。操作人员的经验并不影响引导方法的成功率。
引导式牙髓学可更准确、快速地定位和处理钙化根管，同时显著减少材料损耗。
