Kesharani Pooja R, Aggarwal Shalini D, Patel Nishtha K, Patel Jhanvi, Bansal Ankita, Patel Naman
Dept. of Conservative Dentistry and Endodontics, College of Dental Sciences and Research Centre, Manipur, Ahmedabad, 380058, India.
Dept. of Conservative Dentistry and Endodontics, Dr. D.Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, 411018, India.
J Oral Biol Craniofac Res. 2025 Jul-Aug;15(4):749-756. doi: 10.1016/j.jobcr.2025.04.011. Epub 2025 May 8.
Tooth substance loss during endodontic treatment is a major concern, especially in mandibular incisors due to their minimal tooth volume. Template-guided access cavities help preserve dentin and improve instrument centering. This in vitro study compares remaining dentin thickness (RDT) and centering ability of rotary instruments using both conventional and template-guided approaches in mandibular incisors.
Comparative in vitro CBCT study on remaining dentin thickness and centering ability of rotary instrumentation in mandibular incisors using conventional vs. template-guided access cavity preparation.
Pre-treatment CBCT scans were taken of 80 mandibular incisors, to evaluate the existing dentin thickness and these were then divided into 2 groups of 40 teeth each. Conventional endodontic access cavities were made in Group -1, and guided access openings were done in Group - 2. Post-operative CBCT scans were taken to measure the RDT canal centering ability of each approach.The data was examined using a one-way analysis of variance, followed by Tukey's post-hoc test for multiple pairwise comparisons, with a significance level set at p < 0.05.
The mean RDT was significantly higher in the group where a template-guided access opening was done. The statistical difference for RDT amongst both the experimental groups was highly significant at the Cemento-Enamel Junction and 9 mm from the root apex. Statistically significant results were obtained 6 mm level and insignificant result was obtained at 3 mm level from root apex. No significant differences in the centering ability ratio were observed between the Traditional Endodontic Cavity (TEC) and Guided Endodontic Cavity (GEC) at any level.
Pericervical dentin was preserved more in guided access cavity preparation. The design of the access cavity preparation did not impact the centering ratio of the instruments used for shaping the root canals.
牙髓治疗过程中的牙体组织丧失是一个主要问题，尤其是在下颌切牙，因为它们的牙体体积最小。模板引导的开髓洞形有助于保留牙本质并改善器械就位。这项体外研究比较了在下颌切牙中使用传统方法和模板引导方法时旋转器械的剩余牙本质厚度（RDT）和就位能力。
使用传统开髓洞形制备与模板引导开髓洞形制备，对下颌切牙旋转器械的剩余牙本质厚度和就位能力进行体外CBCT对比研究。
对80颗下颌切牙进行治疗前CBCT扫描，以评估现有的牙本质厚度，然后将其分为两组，每组40颗牙。第1组制备传统牙髓开髓洞形，第2组制备引导开髓洞形。术后进行CBCT扫描，以测量每种方法的RDT根管就位能力。使用单因素方差分析检查数据，随后进行Tukey事后检验以进行多个成对比较，显著性水平设定为p < 0.05。
进行模板引导开髓洞形制备的组的平均RDT显著更高。在牙骨质-釉质界和距根尖9毫米处，两个实验组之间RDT的统计差异非常显著。在距根尖6毫米处获得了统计学显著结果，在距根尖3毫米处获得了无显著结果。在任何水平上，传统牙髓腔（TEC）和引导牙髓腔（GEC）之间的就位能力比均未观察到显著差异。
在引导开髓洞形制备中，颈周牙本质保留更多。开髓洞形制备的设计不影响用于根管预备的器械的就位率。
