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.
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.
J Endod. 2024 Oct;50(10):1448-1454. doi: 10.1016/j.joen.2024.05.018. Epub 2024 Jun 3.
This study aimed to compare the accuracy and operation time (OT) of robotic-assisted endodontic microsurgery (RA-EMS), dynamic navigation-guided (DN-guided) EMS, and static navigation-guided (SN-guided) EMS.
Seventy-two teeth from three sets of standardized jaw models (TrueTooth, DELendo, Santa Barbara, CA) randomly assigned into 3 groups underwent osteotomy and root-end resection. Preoperative plans and postoperative cone-beam computed tomography images were imported into an accuracy analysis system and aligned based on the anatomical structures to assess accuracy. The OT was recorded from the moment the foot pedal was pressed down until the bur reached the target depth. Statistical analyses were conducted using Kruskal-Wallis and Scheirer-Ray-Hare tests, with significance set at P < .05.
RA-EMS exhibited significantly higher accuracy than DN- and SN-guided EMS in terms of platform, angular, and resection angular deviations (P < .05). Additionally, RA-EMS exhibited significantly higher accuracy than DN-guided EMS in resection length deviation (P < .05). Significant differences were also observed in OTs between the 3 approaches, with SN-guided EMS showing the shortest OT, followed by RA-EMS and DN-guided EMS. Differences in jaw types within the DN-guided EMS group were observed in terms of angular deviation (P < .05).
All 3 treatment approaches demonstrated acceptable clinical accuracy and OT. RA-EMS exhibited superior accuracy, suggesting its potential application prospects in endodontics. Further high-quality clinical studies are warranted.
本研究旨在比较机器人辅助根管内显微手术(RA-EMS)、动态导航引导(DN-引导)EMS 和静态导航引导(SN-引导)EMS 的准确性和操作时间(OT)。
72 颗来自三套标准化颌骨模型(TrueTooth、DELendo、Santa Barbara,CA)的牙齿随机分为 3 组进行截骨和根尖切除。将术前计划和术后锥形束计算机断层扫描图像导入准确性分析系统,并根据解剖结构进行对齐,以评估准确性。OT 记录从按下脚踏板到钻头到达目标深度的时间。使用 Kruskal-Wallis 和 Scheirer-Ray-Hare 检验进行统计分析,显著性水平设置为 P <.05。
在平台、角度和切除角度偏差方面,RA-EMS 的准确性明显高于 DN-和 SN-引导 EMS(P <.05)。此外,在切除长度偏差方面,RA-EMS 的准确性明显高于 DN-引导 EMS(P <.05)。3 种方法的 OT 也存在显著差异,SN-引导 EMS 的 OT 最短,其次是 RA-EMS 和 DN-引导 EMS。在 DN-引导 EMS 组中,不同颌骨类型的角度偏差存在差异(P <.05)。
所有 3 种治疗方法均表现出可接受的临床准确性和 OT。RA-EMS 表现出更高的准确性,表明其在根管治疗中的潜在应用前景。需要进一步开展高质量的临床研究。