Universidad Autónoma de Yucatán, Faculty of Dentistry, Mérida, Yucatán, México.
Universidad Autónoma de Yucatán, Faculty of Dentistry, Mérida, Yucatán, México.
J Endod. 2021 Jun;47(6):1007-1013. doi: 10.1016/j.joen.2021.03.005. Epub 2021 Mar 18.
Dynamic navigation systems are used in dental implantology to optimize the accuracy of dental implant placement.
A 30-year-old man was seen at the endodontic clinic of the Universidad Autónoma de Yucatán for pain in the left maxillary lateral incisor. A previously treated tooth with symptomatic apical periodontitis was diagnosed. The patient accepted treatment, and after signing an informed consent form, minimally invasive coronal access was performed through a zirconia crown. Then a post removal was performed with an ultrasonic tip to 2 mm before the apical gutta-percha limit, and the removal of material was completed manually with a K-file.
This case report demonstrates the use of dynamic navigation to remove a post from under a zirconia crown for the retreatment of a failing root canal procedure. The removal of fiber posts from endodontically treated teeth can present a unique challenge for clinicians. Numerous techniques and instrument kits are recommended for the removal of fiber posts, but the risk of excessive root structure damage is a major concern because the ability to differentiate the color difference between peripheral dentin and a bonded fiber post can complicate the accuracy of the removal.
The dynamic navigation system enabled minimally invasive removal of the fiber post with a high degree of accuracy, thus ensuring that there was no unnecessary removal of root structure. Dynamic navigation using real-time monitoring could reduce the attendant risk of iatrogenic errors in complex treatment cases.
动态导航系统被用于口腔种植学中,以优化牙种植体放置的准确性。
一名 30 岁男性因左上侧切牙疼痛前往尤卡坦自治大学的牙髓病学诊所就诊。诊断为有症状的根尖周炎的已治疗牙齿。患者接受了治疗,并在签署知情同意书后,通过氧化锆冠进行微创冠向入口。然后使用超声尖端将一个 2mm 长的根尖止动片去除到根尖牙胶限界前,并用 K 锉手动完成材料的去除。
本病例报告展示了使用动态导航从氧化锆冠下取出纤维桩,以重新治疗失败的根管治疗过程。从牙髓治疗过的牙齿中取出纤维桩可能对临床医生提出独特的挑战。推荐了多种技术和器械套件用于去除纤维桩,但由于区分周边牙本质和粘结纤维桩之间的颜色差异的能力会使去除的准确性复杂化,因此过度去除牙根结构的风险是一个主要关注点。
动态导航系统能够以高精度微创去除纤维桩,从而确保不会不必要地去除根结构。使用实时监测的动态导航可以降低在复杂治疗病例中出现医源性错误的风险。