The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, Hubei 430079, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road 237, Wuhan, Hubei 430079, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China,.
J Dent. 2023 Jul;134:104534. doi: 10.1016/j.jdent.2023.104534. Epub 2023 May 4.
To evaluate the accuracy of a dynamic navigation system (DNS) for guided osteotomy and root-end resection during endodontic microsurgery (EMS) and assess its prognosis.
Nine patients who met inclusion criteria underwent DNS-guided EMS. Osteotomy and root-end resection were performed with assistance of DNS (DHC-ENDO1, DCARER Medical Technology, Suzhou, China). The preoperative virtually planned path and postoperative cone-beam computed tomography images were superimposed using DNS software. Accuracy was assessed based on deviations in the platform, apex, and angle of the osteotomy, as well as in the length and angle of the root-end resection. Follow-up evaluations were performed after at least a year postoperatively.
Among the nine patients (11 teeth with 12 roots), the mean platform, apex, and angular deviation of the osteotomy were 1.05 mm, 1.2 mm, and 6.24°, respectively. The mean length and angle deviation of the root-end resection were 0.46 mm and 4.9°, respectively. Significant differences were observed according to tooth position. The platform and apex deviated significantly less in the posterior than in the anterior teeth (p < .05). No significant differences were observed according to arch type, side, and depth of the surgical path (p > .05). Eight patients were evaluated after at least a year postoperatively; clinical and radiographic evaluation revealed a 90% success rate (9/10 teeth).
This study demonstrated high accuracy of DNS in EMS. Furthermore, DNS-guided EMS had a success rate similar to that of freehand EMS over a short-term follow-up. Further study with a larger sample size is necessary.
The present novel DNS technology is a viable method for guided osteotomy and root-end resection in EMS.
ChiCTR2100042312.
评估动态导航系统（DNS）在根管内微创手术（EMS）中引导截骨和根尖切除的准确性，并评估其预后。
符合纳入标准的 9 名患者接受了 DNS 引导的 EMS。截骨和根尖切除均在 DNS（DHC-ENDO1，DCARER Medical Technology，苏州，中国）的辅助下进行。术前虚拟规划路径和术后锥形束 CT 图像通过 DNS 软件进行叠加。根据截骨平台、根尖和角度、根尖切除长度和角度的偏差来评估准确性。术后至少随访 1 年进行随访评估。
9 名患者（11 颗牙 12 个根）中，截骨平台、根尖和角度偏差的平均值分别为 1.05mm、1.2mm 和 6.24°。根尖切除长度和角度偏差的平均值分别为 0.46mm 和 4.9°。根据牙齿位置，观察到显著差异。后牙截骨平台和根尖的偏差明显小于前牙（p<0.05）。根据弓型、侧别和手术路径深度，无显著差异（p>0.05）。8 名患者在术后至少 1 年进行了评估；临床和影像学评估显示成功率为 90%（10 颗牙中的 9 颗）。
本研究表明，DNS 在 EMS 中具有很高的准确性。此外，在短期随访中，DNS 引导的 EMS 与徒手 EMS 的成功率相似。需要进行更大样本量的研究。
本研究提出的新型 DNS 技术是一种用于 EMS 中引导截骨和根尖切除的可行方法。
ChiCTR2100042312。
