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静态引导牙髓治疗在牙髓腔闭锁时开髓预备的准确性:一项随机对照临床试验

Accuracy of static-guided endodontics for access cavity preparation with pulp canal obliteration: a randomized controlled clinical trial.

作者信息

Li Jiayang, Hu Yufeng, Ma Zhifei, Liu Hui, Cao Liqun, Wei Xiaoling

机构信息

Department of Endodontics, School of Stomatology, Shanghai Stomatological Hospital, Fudan University, 356 Beijing Road East, Huangpu District, Shanghai, 200001, China.

Shanghai Key Laboratory of Craniomaxillofacial Development and Diseases, Fudan University, Shanghai, China.

出版信息

BMC Oral Health. 2025 Jun 6;25(1):933. doi: 10.1186/s12903-025-06275-w.

Abstract

BACKGROUND

Locating calcified canals in teeth with pulp canal obliteration remains particularly challenging. The absence of data from randomized controlled trials conducted in vivo has been a critical gap. The objective of this study was to comprehensively assess the accuracy of static-guided endodontics in addressing the challenges of pulp canal obliteration through a randomized controlled clinical trial, as well as pain during treatment and clinical outcomes.

METHODS

Eighty patients with pulp canal obliteration were selected from July 2020 to March 2022 and randomly divided into two groups. In the freehand group, patients underwent contemporary freehand access cavity preparation. Patients in the static-guided group underwent innovative access cavity preparation using three-dimensional-printed endodontic guides for precise root canal localization. The quantitative accuracy was subsequently evaluated through meticulous assessment of indirect impression scans obtained from the access cavities. Moreover, pain during treatment and clinical outcome were investigated.

RESULTS

All participants were randomly assigned to treatment groups. The static-guided group showed high accuracy, with average deviations of 0.14 ± 0.08 mm at the coronal entry point, 0.35 ± 0.16 mm at the apical point, and an angular deviation of 1.75 ± 0.30 °. These deviations were significantly lower than those in the freehand group (P < 0.0001). No significant difference were found between the groups regarding pain during treatment and clinical outcomes after one year (P > 0.05).

CONCLUSION

This study demonstrates, within its limitations, the static endodontics guides represent an accurate method in locating root canals for pulp canal obliteration through a randomized controlled clinical trial.

TRIAL REGISTRATION

The Chinese Clinical Trial Registry, NO. ChiCTR2000037260 (27/08/2020, retrospectively registered).

摘要

背景

在牙髓腔闭锁的牙齿中定位钙化根管仍然极具挑战性。缺乏体内随机对照试验的数据一直是一个关键空白。本研究的目的是通过一项随机对照临床试验,全面评估静态引导牙髓治疗在应对牙髓腔闭锁挑战方面的准确性,以及治疗过程中的疼痛和临床结果。

方法

选取2020年7月至2022年3月间80例牙髓腔闭锁患者,随机分为两组。徒手操作组患者采用当代徒手开髓预备。静态引导组患者采用三维打印牙髓治疗导板进行创新性开髓预备,以实现根管的精确定位。随后通过对从开髓腔获得的间接印模扫描进行细致评估,来评估定量准确性。此外,还对治疗过程中的疼痛和临床结果进行了研究。

结果

所有参与者均被随机分配至治疗组。静态引导组显示出较高的准确性,在冠部入口点的平均偏差为0.14±0.08毫米,在根尖点的平均偏差为0.35±0.16毫米,角度偏差为1.75±0.30°。这些偏差显著低于徒手操作组(P<0.0001)。两组在治疗过程中的疼痛和一年后的临床结果方面未发现显著差异(P>0.05)。

结论

本研究在其局限性范围内表明,通过随机对照临床试验,静态牙髓治疗导板是一种在牙髓腔闭锁的根管定位中准确的方法。

试验注册

中国临床试验注册中心,注册号:ChiCTR2000037260(2020年8月27日,回顾性注册)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f0c3/12144754/ba945c20bb92/12903_2025_6275_Fig1_HTML.jpg

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