The State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
Suzhou Digital-health Care Co. Ltd, Suzhou, China.
J Endod. 2023 Sep;49(9):1199-1206. doi: 10.1016/j.joen.2023.06.012. Epub 2023 Jun 24.
This study aimed to compare the accuracy and efficiency of dynamic navigation-assisted endodontic microsurgery (DN-EMS) using two different registration methods.
Three-dimensional-printed jaw models, including 40 teeth, were divided into two groups (n = 20). Cone-beam computed tomography images of all teeth were scanned under the same exposing parameters. An endodontic dynamic navigation system (DHC-ENDO1) was used to plan the drilling paths. Dynamic navigation-assisted endodontic microsurgery (DN-EMS) was performed using either U-shaped tube (UT) or tooth cusp (TC) registration method. The accuracy was determined by platform deviation, end deviation, angular deviation, resection angle, and resection length deviation. The registration efficiency was defined as the time required to complete the registration procedure. Osteotomy volume of each resection was calculated by Mimics 21.0. Statistical analyses were performed using IBM SPSS Statistics 24.0. Comparisons between groups were performed using the independent sample t test or Mann-Whitney U test. P < .05 was adopted as significant difference.
The UT group was significantly more accurate in terms of mean platform deviation, end deviation, angular deviation, and resection angle (P < .05). Resection length deviation did not differ significantly between the registration groups. The UT group was significantly more efficient than the TC group (P < .05). No significant differences were found in the osteotomy volumes between the two groups.
In the model-based surgical simulation comparison, DN-EMS based on UT registration is more accurate and efficient than the TC method but requires an additional registration device. TC technique may be a reasonable alternative to UT registration in certain clinical tasks.
本研究旨在比较两种不同注册方法在动态导航辅助根管内微创手术(DN-EMS)中的准确性和效率。
将包括 40 颗牙齿的三维打印颌骨模型分为两组(n=20)。使用相同的暴露参数扫描所有牙齿的锥形束计算机断层扫描图像。使用动态导航系统(DHC-ENDO1)规划钻孔路径。使用 U 形管(UT)或牙尖(TC)注册方法进行动态导航辅助根管内微创手术(DN-EMS)。通过平台偏差、末端偏差、角度偏差、切除角度和切除长度偏差确定准确性。注册效率定义为完成注册程序所需的时间。通过 Mimics 21.0 计算每个切除的骨切体积。使用 IBM SPSS Statistics 24.0 进行统计分析。使用独立样本 t 检验或 Mann-Whitney U 检验比较组间差异。P<.05 被认为具有显著差异。
UT 组在平台偏差、末端偏差、角度偏差和切除角度的平均偏差方面明显更准确(P<.05)。注册组之间的切除长度偏差没有显著差异。UT 组比 TC 组效率更高(P<.05)。两组的骨切体积无显著差异。
在基于模型的手术模拟比较中,基于 UT 注册的 DN-EMS 比 TC 方法更准确、更高效,但需要额外的注册设备。TC 技术在某些临床任务中可能是 UT 注册的合理替代方法。