Department of Conservative Dentistry and Periodontology and Center of Dental Traumatology, University Hospital of Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
Department for Preventive Dentistry, Periodontology and Cariology, University Medical Center Göttingen, Göttingen, Germany.
Clin Oral Investig. 2024 Mar 4;28(3):192. doi: 10.1007/s00784-024-05577-7.
To compare the efficacy of fiber post removal using conventional (CONV) versus guided endodontics (GE) in terms of dentin loss, residual resin material, procedural errors, and working time in vitro.
Ninety human central incisors were root-filled and scanned by micro-computed tomography (CT), then restored with fiber posts and composite. Twenty-four sets of teeth with up to four human maxillary central incisors were fabricated and divided into three groups: conventional post removal by a general dentist (CG) or endodontology specialist (CS) and guided endodontics (GE) by a general dentist, yielding 30 teeth per operator and group. After treatment, the prepared access cavities were volumetrically assessed by micro-CT. Statistical significance was evaluated by one-way analysis of variance followed by post hoc comparisons with Tukey's HSD test and Pearson's chi-squared test for independence.
Both CONV and GE resulted in dentin loss and residual resin material. CS resulted in more dentin loss and less residual resin material than CG and GE (p < .05). All groups had some deviations from the original root canal but no perforations. The shortest working time was observed in the GE group.
Compared to the conventional freehand technique, GE resulted in significantly less radicular dentin loss, a few deviations but no perforations.
Guided endodontics can improve the speed and safety of fiber post removal without root perforation.
比较传统（CONV）和引导牙髓（GE）在根管内纤维桩去除方面的有效性，主要评估在牙本质损失、残余树脂材料、操作失误和工作时间方面的差异。
90 个人工中央前磨牙根管填充后用微计算机断层扫描（CT）扫描，然后用纤维桩和复合树脂修复。共制作了 24 组（每组最多有 4 个人工上颌中切牙），并将其分为三组：普通牙医（CG）或牙髓病专家（CS）进行传统的纤维桩去除术，以及普通牙医进行引导牙髓术（GE），每组每个牙医有 30 颗牙齿。治疗后，通过微 CT 对制备的牙体预备进行体积评估。使用单向方差分析评估统计学意义，然后进行 Tukey 的 HSD 检验和 Pearson 的卡方检验进行组间比较。
CONV 和 GE 均导致牙本质损失和残余树脂材料。CS 导致的牙本质损失比 CG 和 GE 更多，残余树脂材料更少（p <.05）。所有组都有一些偏离原始根管的情况，但没有穿孔。GE 组的工作时间最短。
与传统的徒手技术相比，GE 导致的根管内牙本质损失明显减少，仅有少数偏离但无穿孔。
与传统的徒手技术相比，引导牙髓术可在不发生根管穿孔的情况下提高纤维桩去除的速度和安全性。
