School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil; School of Dentistry, Alfredo Nasser University Center, Aparecida de Goiânia, Goiás, Brazil.
School of Dentistry, Federal University of Goiás, Goiânia, Goiás, Brazil.
J Endod. 2023 Jan;49(1):89-95. doi: 10.1016/j.joen.2022.11.004. Epub 2022 Nov 12.
This study evaluated the precision of a simplified workflow using only preoperative cone-beam computed tomographic (CBCT) scans to gain guided access to root canals of extracted mandibular molars. A workflow using CBCT scanning associated with 3-dimensional oral scanning was used as a reference for comparison. The influence of the presence of coronal restoration in the simplified workflow was also evaluated.
Forty-five mandibular molars were randomized into 3 groups: a control group in which digital planning was performed with CBCT and oral scanning and 2 experimental groups in which digital planning was performed only with CBCT examination. In experimental group 1, teeth had no coronal restorations, whereas in group 2 teeth presented with coronal composite restorations. After digital planning, the teeth were accessed using the guides, and a new CBCT scan was made to overlap the pre- and postoperative examinations. Precision was measured by calculating the deviation between the planned and prepared cavities in millimeters and angle. Data were compared using 1-way analysis of variance (P < .05).
All root canals were accessible after access preparation in all tested groups. Deviations of the planned and prepared access cavities were low, with a mean value of 0.55, 0.58, and 0.47 mm and 1.98°, 2.45°, and 1.43° for the control group, group 1, and group 2, respectively. No significant differences in millimeters or angle were observed among the 3 tested groups (P > .05).
The simplified digital workflow using only CBCT examination allowed a high level of precision in obtaining access in extracted molars with and without coronal restoration, presenting similar results compared with the digital workflow using CBCT and 3-dimensional oral scanning.
本研究评估了一种简化工作流程的精度，该流程仅使用术前锥形束计算机断层扫描（CBCT）扫描即可获得下颌磨牙根管的引导式进入。使用 CBCT 扫描与 3 维口腔扫描相结合的工作流程作为比较参考。还评估了简化工作流程中牙冠修复存在的影响。
45 颗下颌磨牙随机分为 3 组：一组为对照组，使用 CBCT 和口腔扫描进行数字规划；两组为实验组，仅使用 CBCT 检查进行数字规划。在实验组 1 中，牙齿没有牙冠修复体，而在实验组 2 中，牙齿有牙冠复合修复体。在数字规划后，使用导板进入牙齿，并进行新的 CBCT 扫描，以重叠术前和术后检查。通过计算毫米和角度的计划和制备腔之间的偏差来测量精度。使用单因素方差分析（P <.05）比较数据。
在所有测试组中，在进入预备后，所有根管均可进入。计划和制备的进入腔的偏差较小，对照组、实验组 1 和实验组 2 的平均值分别为 0.55、0.58 和 0.47 毫米和 1.98°、2.45°和 1.43°。在 3 个测试组中，毫米或角度均无显著差异（P>.05）。
仅使用 CBCT 检查的简化数字工作流程在获得有和无牙冠修复的下颌磨牙进入方面具有较高的精度，与使用 CBCT 和 3 维口腔扫描的数字工作流程相比，结果相似。
