Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Center of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing Key Laboratory of Digital Stomatology, Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health, NMPA key Laboratory for Dental Materials, Zhongguancun South Avenue 22, Beijing 100081, China.
Department of dentistry, Peking University People's Hospital, Xizhimen South Street 11, Beijing 100044, China.
J Dent. 2023 Jan;128:104367. doi: 10.1016/j.jdent.2022.104367. Epub 2022 Nov 17.
The removal of fiber post is often a challenging task. A 3D printed assembled sleeveless system that guides the head of the handpiece instead of the drill was developed to address this issue. This study aimed to evaluate the accuracy of this novel guide system using an in vitro approach.
A standard maxillary typodont was digitized. The right first molar, the right central incisor, the left first premolar, and the left second molar in the digitized dentition were virtually crown-amputated. Four cylinders (diameter: 6 mm, height: 12 mm) were positioned along the directions of the main roots of these teeth to establish the virtual test model. Ten copies of the test model were printed using light-polymerizing resin. Four assembled sleeveless guide systems targeting the cylindrical axes were designed and printed using titanium alloy. One senior prosthodontist performed the drilling task targeting each cylindrical axis aided by the guide system or freehand (20 teeth each). The drilled models were scanned. The coordinates of the centers of all perforations and circular bases on the coronal and apical surfaces were obtained. The linear and angular deviations between the actual drilling path and the cylindrical axis for each tooth were calculated and analyzed.
The guided group exhibited significantly smaller linear and angular deviations than the freehand group (coronal linear deviation: 0.19 ± 0.09 mm vs. 0.35 ± 0.18 mm, p = 0.0012; apical linear deviation: 0.54 ± 0.19 mm vs. 1.71 ± 0.51 mm, p < 0.001; angular deviation: 2.67 ± 1.07° vs. 8.48 ± 2.86°, p < 0.001).
The accuracy of the 3D printed assembled sleeveless guide system used for fiber post removal is superior to that of the freehand method within the limits of an in vitro design.
For the removal of fiber posts, the present 3D printed sleeveless guide system can provide better accuracy that the conventional freehand method. This may justify the diffusion of the guided technique for fiber post removal.
纤维桩的去除常常是一项具有挑战性的任务。为了解决这个问题,开发了一种 3D 打印组装无袖系统,该系统通过引导机头而不是钻头来引导操作。本研究旨在通过体外方法评估这种新型导向系统的准确性。
对标准上颌模型牙进行数字化。在数字化牙列中虚拟地截冠第一磨牙、右上中切牙、左上第一前磨牙和左下第二磨牙。将四个直径为 6mm、高度为 12mm 的圆柱体沿这些牙齿的主根方向定位,建立虚拟测试模型。使用光聚合树脂打印了十个测试模型的副本。使用钛合金设计并打印了四个针对圆柱轴的组装无袖导向系统。一位资深修复专家使用导向系统或徒手(每 20 颗牙各一次)针对每个圆柱轴执行钻孔任务。对钻孔模型进行扫描。获得所有穿孔和冠状及根尖表面圆形基底中心的坐标。计算并分析了每个牙齿实际钻孔路径与圆柱轴之间的线性和角度偏差。
导向组的线性和角度偏差明显小于徒手组(冠向线性偏差:0.19±0.09mm 比 0.35±0.18mm,p=0.0012;根尖向线性偏差:0.54±0.19mm 比 1.71±0.51mm,p<0.001;角度偏差:2.67±1.07°比 8.48±2.86°,p<0.001)。
在体外设计的限制内,用于纤维桩去除的 3D 打印组装无袖导向系统的准确性优于徒手方法。
对于纤维桩的去除,本研究中使用的 3D 打印无袖导向系统可以提供比传统徒手方法更高的准确性。这可能证明引导技术在纤维桩去除中的应用是合理的。