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机器人辅助微创治疗钙化下颌侧切牙:一例报告

Robot-assisted Minimally Invasive Management of a Calcified Mandibular Lateral Incisor: A Case Report.

作者信息

Liu Yuxin, Lv Bo, Cui Zhiming, Xue Ming, Qu Liu

机构信息

Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.

Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.

出版信息

Int Dent J. 2025 Sep 2;75(6):103884. doi: 10.1016/j.identj.2025.103884.

Abstract

INTRODUCTION AND AIMS

Calcified root canals in mandibular anterior teeth present significant therapeutic challenges due to their narrow anatomy and minimal tolerance for procedural errors. This case report demonstrates the successful integration of robot-assisted navigation with an ultra-fine bur to address these challenges.

METHODS

A 44-year-old male presented with symptomatic chronic apical periodontitis and pulp calcification in a mandibular lateral incisor, 20 years after orthodontic treatment. An autonomous robotic system achieved real-time bur tracking within a dynamic 3D coordinate system through combined Cone-beam computed tomography and intraoral scan data. Ultra-fine instrumentation (bur tip: 0.28 mm) preserved more pericervical dentin during access, while subsequent canal preparation eliminated stress-concentrating ledges through continuous taper formation.

RESULTS

A postoperative periapical radiograph confirmed precise access without iatrogenic errors. A 6-month follow-up demonstrated asymptomatic and periapical healing.

CONCLUSION AND CLINICAL RELEVANCE

This approach reduced operator dependence through automated path execution and established a replicable framework for balancing canal negotiability with structural preservation. Future studies must validate 5-year outcomes and explore cost-reduction strategies for broader clinical adoption.

摘要

引言与目的

下颌前牙的钙化根管因其狭窄的解剖结构和对操作失误的极小耐受度而带来显著的治疗挑战。本病例报告展示了机器人辅助导航与超细车针的成功结合,以应对这些挑战。

方法

一名44岁男性在正畸治疗20年后,下颌侧切牙出现有症状的慢性根尖周炎和牙髓钙化。一个自主机器人系统通过结合锥形束计算机断层扫描和口内扫描数据,在动态三维坐标系中实现了车针的实时跟踪。超细器械(车针尖端:0.28毫米)在开髓时保留了更多的颈部牙本质,而随后的根管预备通过连续锥度形成消除了应力集中的台阶。

结果

术后根尖片证实开髓精确无误,无医源性错误。6个月的随访显示无症状且根尖愈合。

结论与临床意义

这种方法通过自动路径执行减少了对操作者的依赖,并建立了一个可复制的框架,用于在保持根管可操作性与结构保存之间取得平衡。未来的研究必须验证5年的治疗效果,并探索降低成本的策略,以实现更广泛的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/83c6/12444460/377e380a9f12/gr1.jpg

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