Professor of Radiology, CROIF, Diagnostic Imaging Center, Cuiabá, Brazil.
Professor of Endodontics, Department of Stomatology Sciences, Federal University of Goiás, Goiânia, Brazil.
Braz Dent J. 2022 Jul-Aug;33(4):21-30. doi: 10.1590/0103-6440202205078.
A contemporary technological revolution has started a new era in the metaverse of Endodontics, a world of virtual operational possibilities that use an exact replica of the natural structures of the maxillofacial complex. This study describes a modeling method for root canal endoscopy using modern cone-beam CT (CBCT) software in a series of clinical cases. The method consists in acquiring thin CBCT slices (0.10mm) in the coronal, sagittal, and axial planes. A specific 3D volume filter, the pulp cavity filter of the e-Vol DX CBCT software, was used to navigate anatomical root canal microstructures, and to scan them using root canal endoscopy. The pulp cavity filter should be set to synchronize CBCT scans from 2D mode - multiplanar reformations (MPR) - to 3D mode - volumetric reconstruction. This filter, when adopting the option of volumetric reconstruction, the developed algorithm leaves the dentin density in transparent mode so that the pulp cavity may be visualized. The algorithm applied performs the suppression (visual) of areas with dentin density. This ensures 3D visualization of the slices and the microanatomy of the root canal, as well as a dynamic navigation throughout the pulp cavity. This computational modeling method adds new resources to Endodontics, which may impact the predictability of root canal treatments positively. The virtual visualization of the internal anatomy of an exact replica of the canal ensures better communications, reliability, and clinical operationalization. Root canal endoscopy using this novel CBCT filter may be used for clinical applications together with innovative digital and virtual-reality resources that will be naturally incorporated into the principles of Endodontics.
当代技术革命开创了牙髓学元宇宙的新纪元,这是一个充满虚拟操作可能性的世界,利用了颌面复合体自然结构的精确复制品。本研究描述了一种使用现代锥形束 CT(CBCT)软件在一系列临床病例中进行根管内窥镜建模的方法。该方法包括在冠状面、矢状面和轴面获取薄的 CBCT 切片(0.10mm)。使用特定的 3D 体积滤波器,即 e-Vol DX CBCT 软件的牙髓腔滤波器,来导航解剖根管微结构,并使用根管内窥镜对其进行扫描。牙髓腔滤波器应设置为同步 CBCT 扫描从 2D 模式 - 多平面重建(MPR)- 到 3D 模式 - 体积重建。该滤波器在采用体积重建选项时,开发的算法将牙本质密度保留在透明模式下,以便可以可视化牙髓腔。应用的算法执行具有牙本质密度的区域的抑制(可视化)。这确保了切片和根管微解剖的 3D 可视化,以及整个牙髓腔的动态导航。这种计算建模方法为牙髓学增添了新的资源,这可能会积极影响根管治疗的可预测性。对根管精确复制品内部解剖结构的虚拟可视化确保了更好的沟通、可靠性和临床操作性。这种新型 CBCT 滤波器的根管内窥镜检查可与创新的数字和虚拟现实资源一起用于临床应用,这些资源将自然融入牙髓学的原则。