Department of Operative and Esthetic Dentistry, University of Szeged, Faculty of Dentistry, Szeged, Hungary.
dicomLAB Dental, Ltd., Szeged, Hungary.
Head Face Med. 2019 Dec 21;15(1):30. doi: 10.1186/s13005-019-0214-8.
Root-end resection is an endodontic surgical intervention that requires high precision so that all ramifications and lateral canals so as infected tissues are eliminated. An exploratory study was conducted to justify the clinical safety and accuracy of guided root-end resection with a trephine.
Fourteen root-end resections were performed in 11 patients. With the aid of computer tomography and rapid prototyping a stereolithographically fabricated, tooth-supported surgical template was used to guide trephinations. Surgery was performed using the printed surgical stent and a trephine was used not only for the osteotomy but for the root end resection as well.
The root end was successfully and completely resected by the trephine in all cases. No intraoperative complications were observed in any of the cases, and the patients were free of symptoms indicating recurrence or complications at the 6-month follow-up. The median angular deviation of the trephination was 3.95° (95% CI: 2.1-5.9), comparable to the angular deviation of guided implant surgery. The mean apex removal error (ARE) was 0.19 mm (95% CI: 0.03-0.07). The mean osteotomy depth error (ODE) was 0.37 mm (95% CI: 0.15-1.35). Overpenetration was a characteristic finding, which indicates the necessity of a stop-trephine.
Within the limitations of this study, we conclude that our results support the use of guided trephination for root-end resection.
根尖切除术是一种需要高精度的牙髓外科手术干预，以确保所有的分支和侧支以及感染组织都被清除。本探索性研究旨在证明使用环钻引导根尖切除术的临床安全性和准确性。
在 11 名患者中进行了 14 例根尖切除术。借助计算机断层扫描和快速原型制作，制作了一个牙支持的外科模板，通过该模板引导环钻。手术中使用了打印的外科支架，环钻不仅用于截骨，也用于根尖切除。
在所有病例中，环钻都成功且完全切除了根尖。在任何病例中都没有观察到术中并发症，在 6 个月的随访中，患者没有出现复发或并发症的症状。环钻的中位角度偏差为 3.95°（95%可信区间：2.1-5.9），与引导种植手术的角度偏差相当。平均根尖去除误差（ARE）为 0.19 mm（95%可信区间：0.03-0.07）。平均截骨深度误差（ODE）为 0.37 mm（95%可信区间：0.15-1.35）。过切是一个特征性发现，这表明需要使用止挡环钻。
在本研究的限制范围内，我们得出结论，我们的结果支持使用引导环钻进行根尖切除术。
