Ito Ryota, Watanabe Satoshi, Satake Kazuhisa, Saito Ryuma, Okiji Takashi
Department of Pulp Biology and Endodontics, Division of Oral Health Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8549, Japan.
Dent J (Basel). 2024 Oct 18;12(10):333. doi: 10.3390/dj12100333.
BACKGROUND/OBJECTIVES: This study compared the accuracy and efficiency of different surgical-guide (SG)-assisted and freehand drilling techniques for removing fiber posts from maxillary anterior teeth performed by differently experienced operators.
A fiber post was bonded to the root canal of 54 extracted maxillary anterior teeth. After mounting the teeth in the jaw models, SGs were designed by integrating cone-beam computed tomography (CBCT) and intraoral scanner data. Each SG included a custom sleeve. An experienced or inexperienced operator drilled the post using three different techniques: (i) SG-assisted incremental drilling at 2-3 mm (SG1), (ii) SG-assisted one-time drilling to a predetermined depth (SG2), and (iii) freehand incremental drilling without SG (FH; n = 9 in each group). Deviations in coronal, sagittal, and horizontal planes and the angle of deviation were measured.
The SG1 and SG2 groups showed significantly smaller sagittal and horizontal deviations than the FH group, regardless of the operator's experience. The SG2 group had a significantly shorter working time than the SG1 and FH groups. In the FH group, the experienced operator required a significantly shorter working time than the inexperienced operator.
SG-assisted drilling techniques enhanced the accuracy and efficiency of removing fiber posts from the anterior teeth, irrespective of the operator's experience.
背景/目的:本研究比较了不同经验的操作者使用不同手术导板(SG)辅助和徒手钻孔技术从上颌前牙中取出纤维桩的准确性和效率。
将纤维桩粘结到54颗拔除的上颌前牙的根管中。将牙齿安装在颌骨模型中后,通过整合锥形束计算机断层扫描(CBCT)和口内扫描仪数据设计手术导板。每个手术导板都包括一个定制套筒。一位经验丰富或经验不足的操作者使用三种不同技术钻出纤维桩:(i)手术导板辅助以2 - 3毫米进行增量钻孔(SG1),(ii)手术导板辅助一次性钻至预定深度(SG2),以及(iii)无手术导板的徒手增量钻孔(FH;每组n = 9)。测量冠状面、矢状面和水平面的偏差以及偏差角度。
无论操作者经验如何,SG1组和SG2组的矢状面和水平面偏差均显著小于FH组。SG2组的工作时间明显短于SG1组和FH组。在FH组中,经验丰富的操作者所需工作时间明显短于经验不足的操作者。
手术导板辅助钻孔技术提高了从上颌前牙中取出纤维桩的准确性和效率,与操作者的经验无关。