Jonaityte Egle Marija, Bilvinaite Goda, Drukteinis Saulius, Torres Andres
Institute of Dentistry, Faculty of Medicine, Vilnius University, Zalgirio 115, 08217 Vilnius, Lithuania.
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, 3000 Leuven, Belgium.
J Clin Med. 2022 Jun 15;11(12):3441. doi: 10.3390/jcm11123441.
In recent years, the application of Guided Endodontics has gained interest for non-surgical endodontic treatment and retreatment. The newest research focuses on the accuracy of Dynamic Navigation (DN). This article systematically reviewed existing data on the accuracy of non-surgical endodontic treatment procedures that were completed using DN. Following the PRISMA criteria, an electronic database search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Studies comparing the accuracy of non-surgical endodontic treatment using DN and the conventional freehand technique were eligible. The literature search resulted in 176 preliminary records. After the selection process six studies were included. The risk of bias was evaluated using the modified Cochrane Collaboration Risk of Bias 2.0 tool. Five studies examined the aid of DN for planning and executing endodontic access cavities, and one for fiber post removal. In two studies, endodontic access cavities were performed in teeth with pulp canal obliteration. The main outcomes that were measured in the included studies were preparation time, global coronal entry point and apical endpoint deviations, angular deviation, tooth substance loss, qualitative precision, number of unsuccessful attempts or procedural mishaps. The risk of bias was rated from low to raising some concerns. Overall, DN showed increased accuracy compared to the freehanded technique and could be especially helpful in treating highly difficult endodontic cases. Clinical studies are needed to confirm the published in vitro data.
近年来，引导式牙髓治疗在非手术牙髓治疗和再治疗中的应用受到了关注。最新研究聚焦于动态导航（DN）的准确性。本文系统回顾了使用DN完成的非手术牙髓治疗程序准确性的现有数据。按照PRISMA标准，在PubMed、科学网、Scopus和考克兰图书馆进行了电子数据库检索。比较使用DN和传统徒手技术进行非手术牙髓治疗准确性的研究符合要求。文献检索得到176条初步记录。经过筛选过程，纳入了六项研究。使用改良的考克兰协作偏倚风险2.0工具评估偏倚风险。五项研究考察了DN在牙髓治疗开髓洞形规划和操作中的辅助作用，一项研究考察了其在纤维桩取出中的作用。两项研究在牙髓腔闭锁的牙齿上进行了牙髓治疗开髓洞形操作。纳入研究中测量的主要结果包括预备时间、冠方入口点和根尖终点偏差、角度偏差、牙体组织损失、定性精度、不成功尝试次数或操作失误。偏倚风险评级为低到存在一些担忧。总体而言，与徒手技术相比，DN显示出更高的准确性，在治疗极具挑战性的牙髓病例中可能特别有帮助。需要进行临床研究来证实已发表的体外数据。
