Farronato Marco, Torres Andres, Pedano Mariano S, Jacobs Reinhilde
Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Italy.
OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, Leuven, Belgium.
J Dent. 2023 May;132:104476. doi: 10.1016/j.jdent.2023.104476. Epub 2023 Mar 9.
The aim of this study is to evaluate the accuracy in endodontics of a novel augmented reality (AR) method for guided access cavity preparation in 3D-printed jaws.
Two operators with different levels of experience in endodontics performed pre-planned virtually guided access cavities through a novel markerless AR system on three sets of 3D-printed jaw models (Objet Connex 350, Stratasys) mounted on a phantom. After the treatment, a post-operative high-resolution CBCT scan (NewTom VGI Evo, Cefla) was taken for each model and registered to the pre-operative model. All the access cavities were then digitally reconstructed by filling the cavity area using 3D medical software (3-Matic 15.0, materialize). For the anterior teeth and the premolars, the deviation at the coronal and apical entry points as well as the angular deviation of the access cavity were compared to the virtual plan. For the molars, the deviation at the coronal entry point was compared to the virtual plan. Additionally, the surface area of all access cavities at the entry point was measured and compared to the virtual plan. Descriptive statistics for each parameter were performed. A 95% confidence interval was calculated.
A total of 90 access cavities were drilled up to a depth of 4 mm inside the tooth. The mean deviation in the frontal teeth and in the premolars at the entry point was 0.51 mm and 0.77 mm at the apical point, with a mean angular deviation of 8.5° and a mean surface overlap of 57%. The mean deviation for the molars at the entry point was 0.63 mm, with a mean surface overlap of 82%.
The use of AR as a digital guide for endodontic access cavity drilling on different teeth showed promising results and might have potential for clinical use. However, further development and research might be needed before in vivo validation.
本研究旨在评估一种用于在3D打印颌骨中进行引导性开髓洞形制备的新型增强现实(AR)方法在牙髓病学中的准确性。
两名牙髓病学经验水平不同的操作者通过一种新型无标记AR系统,在安装在体模上的三组3D打印颌骨模型(Objet Connex 350,Stratasys)上进行预先计划的虚拟引导开髓洞形制备。治疗后,对每个模型进行术后高分辨率CBCT扫描(NewTom VGI Evo,Cefla),并与术前模型进行配准。然后使用3D医学软件(3-Matic 15.0,Materialize)填充洞形区域,对所有开髓洞形进行数字重建。对于前牙和前磨牙,将冠部和根尖进入点的偏差以及开髓洞形的角度偏差与虚拟计划进行比较。对于磨牙,将冠部进入点的偏差与虚拟计划进行比较。此外,测量所有开髓洞形在进入点的表面积,并与虚拟计划进行比较。对每个参数进行描述性统计。计算95%置信区间。
总共在牙齿内部钻出了90个深度达4毫米的开髓洞形。前牙和前磨牙在进入点的平均偏差在根尖点分别为0.51毫米和0.77毫米,平均角度偏差为8.5°,平均表面重叠率为57%。磨牙在进入点的平均偏差为0.63毫米,平均表面重叠率为82%。
将AR用作不同牙齿牙髓病学开髓洞形钻孔的数字引导显示出有前景的结果,并且可能具有临床应用潜力。然而,在体内验证之前可能需要进一步的开发和研究。