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牙髓病学中的动态导航:范围、益处及挑战——一项系统评价

Dynamic Navigation in Endodontics: Scope, Benefits, and Challenges - A Systematic Review.

作者信息

Kapoor Ankita, Alagarsamy Ragavi, Lal Babu, Rana Amal Singh, Kaur Amandeep, Sharma Sidhartha, Logani Ajay

机构信息

Department of Dental & Oral Surgery, Lady Hardinge Medical College & Hospital, New Delhi, India.

Department of Oral and Maxillofacial Surgery, Maulana Azad Institute of Dental Sciences, New Delhi, India.

出版信息

J Endod. 2025 Apr 24. doi: 10.1016/j.joen.2025.04.010.

Abstract

INTRODUCTION

Teeth exhibiting pulp canal calcification or obliteration, requiring retreatment and microsurgery, present significant challenges and necessitate clinical expertise to negate iatrogenic errors and ensure a successful outcome. Dynamic navigation system (DNS) is a recently emerged technology increasingly utilized in such complex endodontic treatments. The present review consolidates the available information about the application, advantages, disadvantages, and complications of DNS in endodontics.

METHODS

An electronic search was performed on PubMed, Cochrane Library, Semantic Scholar, and Google Scholar databases till April 2024. Studies that performed endodontic procedures utilizing the DNS on humans were included. A risk of bias assessment was done using the Joanna Briggs Institute critical appraisal checklists. Data extraction included type of DNS, application including the teeth treated, advantages, disadvantages, and complications.

RESULTS

Fourteen articles (12 case reports and 2 case series) were included in the review. DNS was used for endodontic surgery (78.3%, n = 7), negotiation of calcified canals (20.5%, n = 6), and endodontic retreatment (1.2%, n = 1). The Navigation systems used were Navident, DHC-ENDO1, and X-guide. The mean follow-up (n = 12) was 9.9 months (range: 1-24 months).

CONCLUSIONS

DNS proves to be a reliable solution for complex endodontic scenarios such as endodontic microsurgery, negotiation of obliterated pulp canals, and endodontic retreatment However, the high initial investment and steep learning curve hinder widespread adoption. Future randomized controlled trials comparing different systems are warranted to further validate the effectiveness.

摘要

引言

牙髓腔钙化或闭锁的牙齿需要再治疗和显微手术,这带来了重大挑战,需要临床专业知识来避免医源性错误并确保成功的治疗结果。动态导航系统(DNS)是一种最近出现的技术,越来越多地用于此类复杂的牙髓治疗中。本综述整合了有关DNS在牙髓病学中的应用、优点、缺点和并发症的现有信息。

方法

截至2024年4月,在PubMed、Cochrane图书馆、语义学者和谷歌学术数据库上进行了电子检索。纳入了在人类身上使用DNS进行牙髓治疗程序的研究。使用乔安娜·布里格斯研究所的批判性评价清单进行偏倚风险评估。数据提取包括DNS的类型、应用(包括治疗的牙齿)、优点、缺点和并发症。

结果

本综述纳入了14篇文章(12篇病例报告和2篇病例系列)。DNS用于牙髓手术(78.3%,n = 7)、钙化根管的疏通(20.5%,n = 6)和牙髓再治疗(1.2%,n = 1)。使用的导航系统有Navident, DHC-ENDO1和X-guide。平均随访时间(n = 12)为9.9个月(范围:1 - 24个月)。

结论

对于牙髓显微手术、闭锁牙髓腔的疏通和牙髓再治疗等复杂的牙髓治疗情况,DNS被证明是一种可靠的解决方案。然而,高昂的初始投资和陡峭的学习曲线阻碍了其广泛应用。未来有必要进行比较不同系统的随机对照试验,以进一步验证其有效性。

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