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体外研究无套管导向根管治疗术对上颌侧切牙复杂根管治疗的准确性

In vitro study on the accuracy of sleeveless guided endodontics and treatment of a complex upper lateral incisor.

机构信息

OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.

Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.

出版信息

J Dent. 2023 Apr;131:104466. doi: 10.1016/j.jdent.2023.104466. Epub 2023 Feb 18.

Abstract

PURPOSE

The present study aims to assess the accuracy of sleeveless guided endodontics for root canal treatment of severe pulp canal obliteration (PCO) in 3D printed jaws. Additionally, the treatment of a complex lateral incisor is presented to illustrate the use of sleeveless guides in a clinical situation.

METHODS

Two cone-beam computed tomography (CBCT) volumes of an upper and lower jaw were selected to design 3D printed models with PCO. Virtual planning of the access cavities was performed from right to left second premolar. Then, the models were mounted into a phantom head to simulate an actual patient. Two operators with different levels of experience in endodontics performed guided access cavities. The handpiece was guided by guiding rails placed against each other on the sides of the tooth. A post-operative CBCT scan was taken for analysis.

RESULTS

Eighty-eight guided access cavities (44 per operator) were drilled on eight 3D printed models. The mean length of the access cavities was 15.3 mm, with a mean coronal and apical deviation of 0.5 mm and 0.7 mm respectively. The mean angular deviation was 1.5. No statistically significant difference was found between operators for the three measured parameters.

CONCLUSIONS

This study demonstrates, within its limitations, that sleveless guides represent an accurate method for guided endodontic treatment. No statistically significant difference between operators was found when using the guide.

CLINICAL SIGNIFICANCE

This method offers a valuable alternative to conventional endodontic guides with similar accuracy results.

摘要

目的

本研究旨在评估无袖引导根管治疗术在 3D 打印颌骨中治疗严重牙髓腔闭锁(PCO)的准确性。此外,还介绍了一例复杂侧切牙的治疗,以说明无袖引导在临床情况下的应用。

方法

选择上下颌的两个锥形束 CT(CBCT)容积,设计具有 PCO 的 3D 打印模型。从右侧第二前磨牙到左侧进行虚拟开髓腔规划。然后,将模型安装到模拟头中,以模拟实际患者。两名具有不同根管治疗经验水平的操作人员进行了引导开髓腔。机头通过放置在牙齿侧面的导向轨引导。术后进行 CBCT 扫描分析。

结果

在八个 3D 打印模型上钻了 88 个引导开髓腔(每个操作人员 44 个)。开髓腔的平均长度为 15.3mm,平均冠向和根尖向偏差分别为 0.5mm 和 0.7mm,平均角向偏差为 1.5°。三个测量参数在操作人员之间无统计学差异。

结论

在其局限性内,本研究表明无袖引导是一种用于牙髓根管治疗的准确方法。使用引导时,操作人员之间无统计学差异。

临床意义

该方法为传统根管治疗导板提供了一种有价值的替代方法,具有相似的准确性结果。

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