Clinical Professor, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
Clinical Assistant Professor, Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
J Endod. 2023 Dec;49(12):1698-1705. doi: 10.1016/j.joen.2023.09.013. Epub 2023 Oct 5.
This study investigates the feasibility of integrating a piezoelectric device (PIEZO) into a dynamic navigation system (DNS) for bone-window guided surgery. It compares the accuracy and efficiency of PIEZO + DNS to PIEZO + Freehand (FH) procedure for bone-window cutting and root-end resection (RER).
Forty-eight mandibular molars of 3D-printed surgical jaw models were divided into two groups: PIEZO + DNS (n = 24) and PIEZO + FH (n = 24). Cone-beam computed tomography scans were taken before and after the procedure. The procedure was virtually planned on X-guide software. The bone-window cutting and RER were conducted with a PIEZO under dynamic navigation in the PIEZO + DNS group and using the dental operating microscope in the PIEZO + FH group. The 2D- and 3D-accuracy deviations and angular deflection were measured for the bone window cut. The root length resected and resection angle were calculated. The bone window cut, RER, total operating time, and number of mishaps were recorded.
PIEZO + DNS was more accurate than PIEZO + FH for bone-window cutting, showing fewer 2D and 3D deviations and less angular deflection (P < .05). The resection angle was lower in the PIEZO + DNS (P < .05). The bone-window cut and total operating time were significantly reduced using a DNS (P < .05). There was no difference in the number of mishaps (P > .05).
Within the limitations of this in vitro study, the integration of a PIEZO into a DNS is feasible for bone-window guided surgery. The DNS improved the accuracy and efficiency of bone-window cutting.
本研究旨在探讨将压电设备（PIEZO）集成到动态导航系统（DNS）中用于骨窗引导手术的可行性。本研究比较了 PIEZO+DNS 和 PIEZO+徒手（FH）程序用于骨窗切割和根尖切除（RER）的准确性和效率。
将 3D 打印手术颌模型的 48 颗下颌磨牙分为两组：PIEZO+DNS（n=24）和 PIEZO+FH（n=24）。在手术前和手术后均进行锥形束 CT 扫描。在 X-guide 软件上进行虚拟规划。在 PIEZO+DNS 组中，在动态导航下使用 PIEZO 进行骨窗切割和 RER，在 PIEZO+FH 组中使用牙科手术显微镜进行骨窗切割和 RER。测量骨窗切割的 2D 和 3D 精度偏差和角度偏斜。计算根尖切除长度和切除角度。记录骨窗切割、RER、总手术时间和意外事件的数量。
PIEZO+DNS 组在骨窗切割方面比 PIEZO+FH 组更准确，2D 和 3D 偏差更小，角度偏斜更小（P<.05）。PIEZO+DNS 组的切除角度更低（P<.05）。使用 DNS 可显著缩短骨窗切割和总手术时间（P<.05）。意外事件的数量无差异（P>.05）。
在本体外研究的限制范围内，将 PIEZO 集成到 DNS 中对于骨窗引导手术是可行的。DNS 提高了骨窗切割的准确性和效率。
