Department of Operative and Esthetic Dentistry, Faculty of Dentistry, University of Szeged, Szeged, Hungary.
dicomLAB Dental, Ltd, Szeged, Hungary.
J Stomatol Oral Maxillofac Surg. 2022 Sep;123(4):388-394. doi: 10.1016/j.jormas.2021.09.014. Epub 2021 Sep 30.
Static guided trephine apicoectomy has been developed as a less invasive and more accurate alternative to conventional freehand apicoectomy with drills. Overpenetration is a frequent issue with this procedure, which deteriorates accuracy and raises safety concerns. A safety improvement to address this problem is presented.
Guided apicoectomies were performed in porcine mandibles with either a conventional bone trephine or a custom-made endo-trephine with built-in depth control. The deviation of the apical endpoint of the trephine from the digital surgical plan was analyzed. Overpenetration frequency was recorded.
Procedures performed with the custom trephine were significantly more accurate both along the x-axis and globally, but no significant difference was found for the y and z axes. Overpenetration frequency was 70% in the conventional trephine group versus 38% in the stop trephine group.
The results indicate that the lack of physical depth control can interfere with the accuracy (and safety) of these procedures to a significant extent, as visual cues (such as the depth markings on a conventional trephine) are insufficient to prevent overpenetration. Our results show that custom-made trephines with a built-in stop offer an optimal solution for this problem.
与传统的徒手用钻头进行的根尖切除术相比，静态引导环钻根尖切除术是一种侵袭性更小、更精确的替代方法。该手术的一个常见问题是过钻，这会降低准确性并引发安全问题。本研究提出了一种针对该问题的安全改进方法。
在猪下颌骨中进行引导根尖切除术，使用传统的骨环钻或带有内置深度控制的定制内环钻。分析环钻根尖终点相对于数字化手术计划的偏差。记录过钻的频率。
使用定制环钻进行的手术在 x 轴和整体上都明显更精确，但 y 和 z 轴没有显著差异。在传统环钻组中，过钻的频率为 70%，而在限位环钻组中为 38%。
结果表明，缺乏物理深度控制会在很大程度上影响这些手术的准确性（和安全性），因为视觉提示（如传统环钻上的深度标记）不足以防止过钻。我们的结果表明，带有内置限位的定制环钻为解决该问题提供了最佳方案。
