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Tang WL, Chao XY, Ye Z, Liu MW, Jiang H. The Use of Dynamic Navigation Systems as a Component of Digital Dentistry. J Dent Res 2024; 103:119-128. [PMID: 38098369 DOI: 10.1177/00220345231212811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024] Open
Abstract
The development of dynamic navigation system (DNS) has facilitated the development of modern digital medicine. In the field of dentistry, the cutting-edge technology is garnering widespread recognition. Based on the principles of 3-dimensional visualization, virtual design, and precise motion tracking, DNS is mainly composed of a computer, a tracking system, specialized tracer instruments, and navigation software. DNS employs a workflow that begins with preoperative data acquisition and imaging data reconstruction, followed by surgical instrument calibration and spatial registration, culminating in real-time guided operations. Currently, the system has been applied in a broad spectrum of dental procedures, encompassing dental implants, oral and maxillofacial surgery (such as tooth extraction, the treatment of maxillofacial fractures, tumors, and foreign bodies, orthognathic surgery, and temporomandibular joint ankylosis surgery), intraosseous anesthesia, and endodontic treatment (including root canal therapy and endodontic surgery). These applications benefit from its enhancements in direct visualization, treatment precision, efficiency, safety, and procedural adaptability. However, the adoption of DNS is not without substantial upfront costs, required comprehensive training, additional preparatory time, and increased radiation exposure. Despite challenges, the ongoing advancements in DNS are poised to broaden its utility and substantially strengthen digital dentistry.
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Affiliation(s)
- W L Tang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - X Y Chao
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - Z Ye
- Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - M W Liu
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
| | - H Jiang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, Hubei, China
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Yang X, Zhang Y, Chen X, Huang L, Qiu X. Limitations and Management of Dynamic Navigation System for Locating Calcified Canals Failure. J Endod 2024; 50:96-105. [PMID: 37890613 DOI: 10.1016/j.joen.2023.10.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/28/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023]
Abstract
Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and spatial location registration, the dynamic navigation technique uses an optical tracking system to guide the clinician to drill in real time according to the predesigned path until access to the canal is established. Several in vitro studies and case reports have shown that calcified canal location with dynamic navigation system (DNS) is more accurate and efficient, yet the technique has limitations. In 4 cases with 7 teeth, this work presents manipulation process and clinical outcomes of DNS helping in calcified canal location. We performed handpiece adaptation and elucidated the failure to locate the canals with DNS in 2 teeth, resulting in canal geometry alteration and canal path deviation. Subsequently, the more experienced endodontist located the canals by combining cone-beam computed tomographic imaging and dental operating microscopy. All patients were completely asymptomatic after treatment. At the 1-year follow-up visit, the bone healing of periapical lesions progressed well according to the periapical radiography or cone-beam computed tomographic imaging. These findings indicate that DNS is a promising technique for locating calcified canals; however, it needs to be refined before clinical use.
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Affiliation(s)
- Xiaoxia Yang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Yinchun Zhang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xuan Chen
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
| | - Lei Huang
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China
| | - Xiaoling Qiu
- Department of Endodontics, Stomatological Hospital, School of Stomatology, Southern Medical University, Guangzhou, China.
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Lima TO, Rocha ADO, Dos Anjos LM, Meneses Júnior NS, Hungaro Duarte MA, Alcalde MP, Cardoso M, Vivan RR. A Global Overview of Guided Endodontics: A Bibliometric Analysis. J Endod 2024; 50:10-16. [PMID: 37838017 DOI: 10.1016/j.joen.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 10/07/2023] [Indexed: 10/16/2023]
Abstract
INTRODUCTION This review aimed to analyze the trend and main characteristics of articles related to guided endodontics (GE). METHODS The search was conducted in May 2023 on Web of Science. GE-related articles were included, and conferences were excluded. Three researchers selected the articles and extracted: the number of citations; year and journal; design and study theme; authorship and institutions; country and continent. Collaborative networks were generated in the Visualization of Similarities Viewer software. The relationship between data was determined by Spearman's correlation. Google Trends was used to investigate the global popularity of GE research. RESULTS The search resulted in 135 articles, of which 85 were included. The most cited article totaled 116 citations. The studies were published between 2016 and 2023, most frequently in 2022 (n = 22). The most prevalent journal was the Journal of Endodontics (n = 28). Case report (n = 38) was the most frequent study design. The most studied theme was the use of static GE for calcified canals (n = 27). Connert T was the author with the highest number of articles (n = 13). The University of Basel (n = 9) stood out. The most prevalent country was Brazil (n = 13). Europe was the most frequent continent (n = 38). Visualization of Similarities Viewer demonstrated an interaction between authors. There was a moderate positive correlation between citations and the impact factor (rho = .483). According to Google Trends, the United States was the country that most researched GE. CONCLUSIONS Based on this review, a more significant research interest in GE was observed in Europe, addressing the application of GE in locating severely calcified root canals.
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Affiliation(s)
| | - Aurélio de Oliveira Rocha
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
| | - Lucas Menezes Dos Anjos
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | | | | | | | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Rodrigo Ricci Vivan
- Department of Endodontics, University of São Paulo, Bauru, São Paulo, Brazil
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Wei X, Du Y, Zhou X, Yue L, Yu Q, Hou B, Chen Z, Liang J, Chen W, Qiu L, Huang X, Meng L, Huang D, Wang X, Tian Y, Tang Z, Zhang Q, Miao L, Zhao J, Yang D, Yang J, Ling J. Expert consensus on digital guided therapy for endodontic diseases. Int J Oral Sci 2023; 15:54. [PMID: 38052782 DOI: 10.1038/s41368-023-00261-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/12/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023] Open
Abstract
Digital guided therapy (DGT) has been advocated as a contemporary computer-aided technique for treating endodontic diseases in recent decades. The concept of DGT for endodontic diseases is categorized into static guided endodontics (SGE), necessitating a meticulously designed template, and dynamic guided endodontics (DGE), which utilizes an optical triangulation tracking system. Based on cone-beam computed tomography (CBCT) images superimposed with or without oral scan (OS) data, a virtual template is crafted through software and subsequently translated into a 3-dimensional (3D) printing for SGE, while the system guides the drilling path with a real-time navigation in DGE. DGT was reported to resolve a series of challenging endodontic cases, including teeth with pulp obliteration, teeth with anatomical abnormalities, teeth requiring retreatment, posterior teeth needing endodontic microsurgery, and tooth autotransplantation. Case reports and basic researches all demonstrate that DGT stand as a precise, time-saving, and minimally invasive approach in contrast to conventional freehand method. This expert consensus mainly introduces the case selection, general workflow, evaluation, and impact factor of DGT, which could provide an alternative working strategy in endodontic treatment.
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Affiliation(s)
- Xi Wei
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Yu Du
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Xuedong Zhou
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lin Yue
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Qing Yu
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Benxiang Hou
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China
| | - Zhi Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Jingping Liang
- Department of Endodontics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Clinical Research Center for Oral Diseases; National Center for Stomatology; Shanghai Key Laboratory of Stomatology, Shanghai, China
| | - Wenxia Chen
- College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Lihong Qiu
- Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China
| | - Xiangya Huang
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Dingming Huang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China
| | - Yu Tian
- Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi'an, China
| | - Zisheng Tang
- Department of Stomatology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Zhang
- Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China
| | - Leiying Miao
- Department of Cariology and Endodontics, Nanjing Stomatological Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jin Zhao
- Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China
| | - Deqin Yang
- Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Jian Yang
- Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China
| | - Junqi Ling
- Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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Kaabi HH, Riyahi AM, Al-Maflehi NS, Alrumayyan SF, Bakrman AK, Almutaw YA. Three-dimensional analysis for detection of pulp stones in a Saudi population using cone beam computed tomography. J Oral Sci 2023; 65:257-260. [PMID: 37612065 DOI: 10.2334/josnusd.23-0091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE To assess the prevalence and distribution of pulp stones in a Saudi population. METHODS A cone beam computed tomography (CBCT) analysis of 150 upper and 150 lower dental arches was performed. The relationships between pulp stones and age, sex, tooth type, dental arch, orthodontic treatment, caries, and restoration were statistically examined (P < 0.05). RESULTS A total of 295 dental arches (98.3%) had at least one pulp stone, and the prevalence was higher in the maxillary teeth (56.2%) than in the mandibular teeth (48.1%) (P = 0.0003). Men were more likely to have pulp stones than women (P = 0.011 for the maxilla, P < 0.0001 for the mandible). Furthermore, age and orthodontic treatment had no significant effects on the incidence of pulp stones (P > 0.05). A higher occurrence of pulp stones was observed in the first molars (>91%), and in carious and restored teeth when compared to intact teeth (P < 0.05). CONCLUSION Pulp stones were more prevalent in the upper dental arches, first molars, and carious and restored teeth, as well as in the male population, and were not associated with age or orthodontic treatment.
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Affiliation(s)
- Hassan H Kaabi
- Division of Oral Biology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University
| | - Abdullah M Riyahi
- Division of Endodontic Dentistry, Department of Restorative Dental Sciences, College of Dentistry, King Saud University
| | - Nassr S Al-Maflehi
- Division of Community Dentistry, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University
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Mekhdieva E, Del Fabbro M, Alovisi M, Scotti N, Comba A, Berutti E, Pasqualini D. Dynamic Navigation System vs. Free-Hand Approach in Microsurgical and Non-Surgical Endodontics: A Systematic Review and Meta-Analysis of Experimental Studies. J Clin Med 2023; 12:5845. [PMID: 37762786 PMCID: PMC10531643 DOI: 10.3390/jcm12185845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/27/2023] [Accepted: 09/04/2023] [Indexed: 09/29/2023] Open
Abstract
(1) Background: A Dynamic Navigation System (DNS) is an innovative tool that facilitates the management of complex endodontic cases. Despite the number of advantages and limitations of this approach, there is no evidence-based information about its efficiency in comparison with that of the traditional method in endodontics. (2) Objectives: We aimed to explore any beneficial effects of the DNS and compare the outcomes of DNS vs. free-hand (FH) approaches for non-surgical and microsurgical endodontics. (3) Methods: A literature search was conducted in August 2023 to identify randomized, experimental, non-surgical, and microsurgical endodontic studies that compared the DNS with FH approaches. The procedural time (ΔT, s), substance loss (ΔV, mm3), angular deviation (ΔAD, °), coronal/platform linear deviation (ΔLD_C, mm), and apical linear deviation (ΔLD_A, mm) were recorded and analyzed. Quality and risk of bias assessments were conducted according to the Quality Assessment Tool For In Vitro Studies. A meta-analysis was performed using mean difference and standard deviation for each outcome, and heterogeneity (I2) was estimated. p < 0.05 was considered significant. (4) Results: One-hundred and forty-six studies were identified following duplicate removal, and nine were included in the systematic review and meta-analysis. The overall risk of bias was classified as low. The DNS was found to be more accurate and efficient than the FH approach was, resulting in a significantly shorter operation time (p < 0.00001) and less angular (p ≤ 0.0001) and linear deviation (p ≤ 0.01). For substance loss, the advantage of the DNS was significant only for microsurgery (p = 0.65, and p < 0.005, for non-surgical and microsurgical procedures, respectively). A reduced risk of iatrogenic failure using the DNS was observed for both expert and novice operators. (5) Conclusions: The DNS appears beneficial for non-surgical and microsurgical endodontics, regardless of the operator's experience. However, appropriate training and experience are necessary to access the full advantages offered by the DNS.
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Affiliation(s)
- Elina Mekhdieva
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
| | - Massimo Del Fabbro
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20133 Milan, Italy;
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Mario Alovisi
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
| | - Nicola Scotti
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
| | - Allegra Comba
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
| | - Elio Berutti
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
| | - Damiano Pasqualini
- Department of Surgical Sciences, Dental School, Endodontics and Operative Dentistry, University of Turin, 10124 Torino, Italy; (M.A.); (N.S.); (A.C.); (E.B.); (D.P.)
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Pires CRF, Souza-Gabriel AE, Pelozo LL, Cruz-Filho AM, Sousa-Neto MD, Silva RG. Guided endodontics of calcified canals: The drilling path of rotary systems and intracanal dentin wear. AUST ENDOD J 2023; 49 Suppl 1:64-70. [PMID: 36106713 DOI: 10.1111/aej.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/03/2022] [Indexed: 11/26/2022]
Abstract
This study evaluated the drilling path (mm) and the dentin wear (mm3 ) of two instruments used during guided endodontic access. Twenty mandibular incisors with calcified canals were selected using cone-beam computed tomography (CBCT) and fixed in articulated models. Preoperative CBCT scans were performed in combination with intraoral scanning, and the images were reconstructed in the Blue Sky Bio software for access planning and printing the guides. The access cavity was drilled with 1.0-mm-diameter bur (DSP) and 0.8-mm-diameter bur (Munce). Postoperative CBCT was performed, and the images obtained preoperative and postoperative were superimposed for the analyses. Data were analysed by a t-test and linear regression (α = 0.05). No difference was found in the drilling path (p = 0.422). However, the Munce bur had higher dentin wear than the DSP bur (p = 0.011). A positive linear correlation (R2 = 0.859) was found between the factors.
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Affiliation(s)
| | | | - Laís Lima Pelozo
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Antônio Miranda Cruz-Filho
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Manoel Damião Sousa-Neto
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Gariba Silva
- Department of Restorative Dentistry, School of Dentistry of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
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Karim MH, Faraj BM. Comparative Evaluation of a Dynamic Navigation System versus a Three-dimensional Microscope in Retrieving Separated Endodontic Files: An In Vitro Study. J Endod 2023; 49:1191-1198. [PMID: 37393950 DOI: 10.1016/j.joen.2023.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION This study aimed to compare the effectiveness of a dynamic navigation system and a three-dimensional microscope in retrieving broken rotary Nickel-Titanium files when using trepan burs and the extractor system. MATERIALS AND METHODS Thirty maxillary first bicuspids with 60 separate roots were split into 2 comparable groups based on a comprehensive cone beam computed tomography analysis of the root length and curvature. After standardized access opening, glide paths, and patency attainment with the K file (sizes 10 and 15), the teeth were arranged on 3D models (three per quadrant, six per model). Subsequently, controlled-memory heat-treated Nickel-Titanium rotary files (#25/0.04) were notched 4 mm from the tips and fractured at the apical third of the roots. The C-FR1 Endo file removal system was employed under both guidance to retrieve the fragments, and the success rate, canal aberration, treatment time, and volumetric changes were measured. The statistical analysis was performed using IBM SPSS software at a significance level of 0.05. RESULTS The microscope-guided group had a higher success rate than the dynamic navigation system guidance, but the difference was insignificant (P > .05). In addition, the microscope-guided drills resulted in a substantially lower proportion of canal aberration, shorter time to retrieve the fragments and less change in the root canal volume (P < .05). CONCLUSION Although dynamically guided trephining with the extractor can retrieve separated instruments, it is inferior to three-dimensional microscope guidance regarding treatment time, procedural errors, and volume change.
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Affiliation(s)
- Mohammed H Karim
- Conservative Department, University of Sulaimani, College of Dentistry, Iraq.
| | - Bestoon M Faraj
- Conservative Department, University of Sulaimani, College of Dentistry, Iraq
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Martinho FC, Griffin IL, Corazza BJM. Current Applications of Dynamic Navigation System in Endodontics: A Scoping Review. Eur J Dent 2023; 17:569-586. [PMID: 36044911 PMCID: PMC10569848 DOI: 10.1055/s-0042-1749361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
This scoping review (SCR) was conducted to map the existing literature on dynamic navigation system (DNS), to examine the extent, range, and nature of research activity. Additionally, this SCR disseminates research findings, determines the value of conducting a full systematic review with meta-analysis, and identifies gaps in the existing literature and future directions. This SCR followed Arksey and O'Malley's five stages framework. The electronic search was performed in PubMed (Medline), Scopus (Elsevier), and Web of Science (Clarivate Analytics) databases using a search strategy. Five themes emerged during the descriptive analysis that captured the DNS application in endodontics. The DNS has been explored for creating access cavities (8/18, 44.44%), locating calcified canals (4/18, 22.2%), microsurgery (3/18, 16.6%), post removal (2/18, 11.1%), and intraosseous anesthesia (1/18, 5.5%). Out of the 18 studies included, 12 are in vitro (66.6%), five are in vivo (case report) (27.7%), and one is ex vivo (5.5%). The DNS demonstrated accuracy and efficiency in performing minimally invasive access cavities, locating calcified canals, and performing endodontic microsurgery, and it helped target the site for intraosseous anesthesia.
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Affiliation(s)
- Frederico Canato Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland
| | - Ina Laurie Griffin
- Division of Endodontics, Department of Restorative Dentistry, São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
| | - Bruna Jordão Motta Corazza
- Division of Endodontics, Department of Restorative Dentistry, São Paulo State University, Institute of Science and Technology, São José dos Campos, São Paulo, Brazil
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Chen C, Zhang R, Zhang W, Wang F, Wang Z, Qin L, Bian Z, Meng L. Analysis of the Accuracy of a Dynamic Navigation System in Endodontic Microsurgery: A Prospective Case Series Study: Accuracy of DNS in EMS. J Dent 2023; 134:104534. [PMID: 37149255 DOI: 10.1016/j.jdent.2023.104534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/08/2023] Open
Abstract
OBJECTIVES To evaluate the accuracy of a dynamic navigation system (DNS) for guided osteotomy and root-end resection during endodontic microsurgery (EMS) and assess its prognosis. METHODS Nine patients who met inclusion criteria underwent DNS-guided EMS. Osteotomy and root-end resection were performed with assistance of DNS (DHC-ENDO1, DCARER Medical Technology, Suzhou, China). The preoperative virtually planned path and postoperative cone-beam computed tomography images were superimposed using DNS software. Accuracy was assessed based on deviations in the platform, apex, and angle of the osteotomy, as well as in the length and angle of the root-end resection. Follow-up evaluations were performed after at least a year postoperatively. RESULTS Among the nine patients (11 teeth with 12 roots), the mean platform, apex, and angular deviation of the osteotomy were 1.05 mm, 1.2 mm, and 6.24°, respectively. The mean length and angle deviation of the root-end resection were 0.46 mm and 4.9°, respectively. Significant differences were observed according to tooth position. The platform and apex deviated significantly less in the posterior than in the anterior teeth (p < .05). No significant differences were observed according to arch type, side, and depth of the surgical path (p > .05). Eight patients were evaluated after at least a year postoperatively; clinical and radiographic evaluation revealed a 90% success rate (9/10 teeth). CONCLUSIONS This study demonstrated high accuracy of DNS in EMS. Furthermore, DNS-guided EMS had a success rate similar to that of freehand EMS over a short-term follow-up. Further study with a larger sample size is necessary. CLINICAL SIGNIFICANCE The present novel DNS technology is a viable method for guided osteotomy and root-end resection in EMS. CLINICAL TRIAL REGISTRATION NUMBER ChiCTR2100042312.
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Affiliation(s)
- Chen Chen
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Rui Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Wei Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Fushi Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zan Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Li Qin
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Zhuan Bian
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Liuyan Meng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China;.
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Panithini DB, Sajjan GS, Kinariwala N, Medicharla UD, Varma KM, Kallepalli M. Real-time guided endodontics: A case report of maxillary central incisor with calcific metamorphosis. J Conserv Dent 2023; 26:113-117. [PMID: 36908734 PMCID: PMC10003280 DOI: 10.4103/jcd.jcd_506_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 12/12/2022] Open
Abstract
Dental trauma results in various complications and poses an enigma to the practitioner. Calcific metamorphosis is one of the sequelae of trauma. A female patient of 35 years visited the specialty clinic of endodontics for the management of a discolored tooth. Clinically, discolored 21 was observed with no pain on palpation and percussion. The pulp sensibility test revealed a negative response. Radiographic examination revealed pulp canal obliteration with an apical radiolucency of Peri Apical Index (PAI 4). The tooth was diagnosed as necrotic pulp with asymptomatic apical periodontitis. Attempt to negotiate the canal under a Dental Operating Microscope (LABOMED, Los Angeles, CA, USA) and ultrasonics (Satelec, Acteon, France) was futile. Cone-beam computed tomography image revealed a patent canal in the apical third. Using real-time guided endodontics with a dynamic navigation system (Navident, ClaroNav, Toronto, ON, Canada), the protocol of plan, trace, and place was followed, and successful canal negotiation was achieved. After radiographic confirmation, root canal treatment was completed.
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Affiliation(s)
- Durga Bhavani Panithini
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Girija S. Sajjan
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Niraj Kinariwala
- Department of Conservative Dentistry, Karnavati University, Gandhinagar, Gujarat, India
| | - Uma Devi Medicharla
- Department of Conservative Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - K. Madhu Varma
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
| | - Meghana Kallepalli
- Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
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Wu J, Heng M, Bai Y. A novel dice-inspired multifunctional 3D printing guided splint for minimally invasive access cavity preparation and canal orifice identification. Technol Health Care 2023; 31:2381-2387. [PMID: 37302052 DOI: 10.3233/thc-230002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND The minimally invasive endodontics could retain more peri-cervical dentin (PCD) and other important dental structures, thus realizing the minimal loss of teeth structures and preserving the strength and function of the endodontically treated tooth (ETT). The search for abnormal root canals or calcified root canals could be quite time-consuming and increase the risk of perforation. OBJECTIVE This study introduced a novel multifunctional 3D printing guided splint inspired by the dice, which can achieve the minimally invasive access cavity preparation and canal orifice identification. METHOD Data were collected from an outpatient with dens invaginatus. Cone-beam Computed Tomography (CBCT) revealed a type III invagination. The CBCT data of the patient were imported into a computer-aided design (CAD) software (Exocad 3.0; Exocad GmbH) for the 3D reconstruction of jaw bones and teeth. The dice-inspired 3D printing guided splint consists of the sleeve and guided splint. The sleeve with minimal invasive opening channel and orifice locating channel were designed with a reverse-engineering software (Geomagic Wrap 2021). The reconstructed models in the Standard Template Library (STL) format were imported into a CAD software. The design of the template was aided by the dental CAD software in Splint Design Mode. The sleeve and splint were exported into the STL files separately. A 3D printer (ProJet® 3600 3D Systems) was used to separately generate the sleeve and guided splint, and was made by stereolithography and processed in a medical resin (VisiJet M3 StonePlast). RESULTS The novel multifunctional 3D printing guided splint could be set in position. The opening side in the sleeve was selected and the sleeve was inserted in place. The minimal invasive opening was made in the crown of the tooth to access the pulp. The sleeve was draw out and turned to the orifice location side, and then inserted in place. The target orifice was located rapidly. CONCLUSION This novel dice-inspired multifunctional 3D printing guided splint allow dental practitioners to gain accurate, conservative, and safe cavity access from teeth with anatomical malformations. Complex operations might be carried out with less reliance on the operator's experience than with conventional access preparations. This novel dice-inspired multifunctional 3D printing guided splint would have a broad application in the dental field.
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Affiliation(s)
- Jiaqi Wu
- First Clinical Division, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Modi Heng
- Dental Laboratory Center, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Yunyang Bai
- Department of Geriatric Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
- National Center for Stomatology, School and Hospital of Stomatology, Peking University, Beijing, China
- National Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Peking University, Beijing, China
- National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, School and Hospital of Stomatology, Peking University, Beijing, China
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13
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Han B, Wang Y, Zheng C, Peng L, Sun Y, Wang Z, Wang X. Evaluation of a dynamic navigation system for endodontic microsurgery: study protocol for a randomised controlled trial. BMJ Open 2022; 12:e064901. [PMID: 36523218 PMCID: PMC9748954 DOI: 10.1136/bmjopen-2022-064901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Endodontic microsurgery is a very important technique for preserving the natural teeth. The outcomes of endodontic microsurgery largely depend on the skill and experience of the operators, especially for cases in which the apices are located far away from the labial/buccal cortical bone. A dynamic navigation system (DNS) could provide a more accurate and efficient way to carry out endodontic microsurgery. This study is devoted to comparing the clinical outcomes of the DNS technique with those of the freehand technique. METHODS AND ANALYSIS Sixteen patients will be randomly assigned to one of two groups. For the experimental group, the osteotomy and root-end resection will be performed under the guidance of dynamic navigation. For the control group, these procedures will be performed freehand by an endodontist. The required time to perform these procedures will be used to evaluate the efficiency of the DNS technique. A Visual Analogue Scale will be used to evaluate pain at 1, 3 and 7 days after endodontic microsurgery. Preoperative and postoperative cone beam CT scans will be obtained to evaluate the accuracy of the DNS technique. The global coronal deviations, the apical deviations and the angular deflection will be measured. The root-end resection length deviation, the root-end resection angle deviations, the extent of the osteotomy and the volume change of the buccal cortical bone will also be measured. Periapical radiographs will be obtained to evaluate the outcome at 1 year after microsurgery. The time to execute the study, including follow-ups, will last from 1 June 2022 to 31 December 2025. ETHICS AND DISSEMINATION The present study has received approval from the Ethics Committee of Peking University School and Hospital of Stomatology. The results will be disseminated through scientific journals. TRIAL REGISTRATION NUMBER ChiCTR2200059389.
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Affiliation(s)
- Bing Han
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Yuhan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Chunyan Zheng
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Li Peng
- Department of General Dentistry Ⅱ, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Yuchun Sun
- Center of Digital Dentistry, Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Zuhua Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
| | - Xiaoyan Wang
- Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology, Research Center of Engineering and Technology for Digital Dentistry of Ministry of Health, Beijing Key Laboratory of Digital Stomatology, National Clinical Research Center for Oral Diseases, Beijing, China
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Chu T, Ni X, Zhu Y, Ali L. EDTA Combined with C-Pilot Files and Microultrasound for Root Canal Calcification: Dredging Effect and Safety Analysis. Computational and Mathematical Methods in Medicine 2022; 2022:1-6. [PMID: 36267312 PMCID: PMC9578881 DOI: 10.1155/2022/1911448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 09/19/2022] [Accepted: 09/22/2022] [Indexed: 11/27/2022]
Abstract
Objective This paper discussed the dredging effect and safety of ethylenediaminetetraacetic acid (EDTA) combined with C-pilot files and microultrasound (mUS) on root canal calcification. Methods From October 2021 to January 2022, 132 patients with calcified root canals treated in our hospital were selected as the research subjects. Among them, 64 cases who received EDTA combined with C-pilot Files and mUS plus ultrasonic instruments to dredge calcified root canals were regarded as the research group (RG), and another 68 cases given ultrasonic instruments plus C-pilot files were regarded as the control group (CG). The root canal dredging time was recorded, and the dredging success rate and total success rate of different tooth positions and calcification sites were compared between groups. The clinical efficacy was assessed 6 months after treatment. Pain severity was evaluated by the Pain Intensity Numerical Rating Scale (PI-NRS) before (T0), during (T1), and after treatment (T2). Finally, the incidence of adverse reactions within one week after treatment was counted. Results RG was observed with statistically higher success rates of root canal dredging in different tooth positions and calcified sites than CG (P < 0.05). Besides, the total effective rate of treatment was 92.19% in RG, which was also higher compared with CG, while the root canal dredging time in RG was shorter than that in CG (P < 0.05). Increased NRS scores were found in both groups at T1, and the score in RG was significantly lower compared with that in CG. At T2, both groups showed a lower PI-NRS score than T1 but higher than T0, and the score at T2 was also lower in RG as compared to CG (P < 0.05). Moreover, the reduced incidence of adverse reactions were observed in RG compared with CG (P < 0.05). Conclusions EDTA combined with C-pilot files and mUS can effectively improve the dredging success rate of root canals obstructed by calcification, shorten the dredging time, and improve patient comfort, which is an effective method for clinical dredging of calcification obstructed root canals.
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Abstract
Luxation injuries and other stimuli may lead to a pulp canal obliteration (PCO). Even though the apposition of tertiary dentine is a sign of a vital pulp, in some cases root canal treatment is indicated in the long term due to apical periodontitis or pulpitis. Depending on the extent of PCO, root canal treatment may be challenging even for experienced and well-equipped endodontic specialists. The 'guided endodontics' (GE) technique was introduced 6 years ago as an alternative to conventional access cavity preparation for teeth with PCO and apical pathosis or irreversible pulpitis. Using three-dimensional radiological imaging such as cone-beam computed tomography and a digital surface scan, an optimal access to the orifice of the calcified root canal can be planned virtually with appropriate software. GE is implemented either with the help of templates analogous to guided implantology (= static navigation) or by means of dynamic navigation based on a camera-marker system. GE has emerged as a field of research in the last 6 years with very promising laboratory-based results regarding the accuracy of guided endodontic access cavities for both static and dynamic navigation. Clinical implementation seems to provide favourable results, but the evidence is mainly based on numerous case reports and a few case series. This narrative review aims to provide an update on the present status of GE and to identify relevant research areas that could contribute to further improvements of this technique.
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Affiliation(s)
- Thomas Connert
- Department of Periodontology, Endodontology and CariologyUniversity Center for Dental Medicine Basel UZBUniversity of BaselBaselSwitzerland
| | - Roland Weiger
- Department of Periodontology, Endodontology and CariologyUniversity Center for Dental Medicine Basel UZBUniversity of BaselBaselSwitzerland
| | - Gabriel Krastl
- Department of Conservative Dentistry and PeriodontologyUniversity Hospital of WürzburgWürzburgGermany
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Wu M, Liu M, Cheng Y, Tang W, Yan P, Jiang H. Treatment of Pulp Canal Obliteration Using a Dynamic Navigation System: Two Case Reports. J Endod 2022; 48:1441-1446. [PMID: 35963323 DOI: 10.1016/j.joen.2022.07.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 07/15/2022] [Accepted: 07/31/2022] [Indexed: 10/31/2022]
Abstract
Endodontic treatment of calcified canals presents a major challenge because of the high incidence of complications, such as perforation, canal geometry alteration, and loss of dental hard tissue. The dynamic navigation technique uses an optical tracking system for real-time navigation to guide the operator to drill according to the preoperative plan and obtain access to the calcified canals. This article describes in detail the use, advantages, disadvantages, and limitations of a novel dynamic navigation system (DNS) in two cases with severely calcified canals. The findings in these cases demonstrate that DNS is a promising technique for the location of calcified root canals.
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Affiliation(s)
- Mengyan Wu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Mingwen Liu
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Geriatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Yue Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Weilong Tang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Preventive Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Ping Yan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Geriatric Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China
| | - Han Jiang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan 430079, China; Department of Preventive Dentistry, School and Hospital of Stomatology, Wuhan University, Wuhan 430079, China.
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Jonaityte EM, Bilvinaite G, Drukteinis S, Torres A. Accuracy of Dynamic Navigation for Non-Surgical Endodontic Treatment: A Systematic Review. J Clin Med 2022; 11:3441. [PMID: 35743515 DOI: 10.3390/jcm11123441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/10/2022] [Accepted: 06/13/2022] [Indexed: 01/27/2023] Open
Abstract
In recent years, the application of Guided Endodontics has gained interest for non-surgical endodontic treatment and retreatment. The newest research focuses on the accuracy of Dynamic Navigation (DN). This article systematically reviewed existing data on the accuracy of non-surgical endodontic treatment procedures that were completed using DN. Following the PRISMA criteria, an electronic database search was conducted in PubMed, Web of Science, Scopus, and Cochrane Library. Studies comparing the accuracy of non-surgical endodontic treatment using DN and the conventional freehand technique were eligible. The literature search resulted in 176 preliminary records. After the selection process six studies were included. The risk of bias was evaluated using the modified Cochrane Collaboration Risk of Bias 2.0 tool. Five studies examined the aid of DN for planning and executing endodontic access cavities, and one for fiber post removal. In two studies, endodontic access cavities were performed in teeth with pulp canal obliteration. The main outcomes that were measured in the included studies were preparation time, global coronal entry point and apical endpoint deviations, angular deviation, tooth substance loss, qualitative precision, number of unsuccessful attempts or procedural mishaps. The risk of bias was rated from low to raising some concerns. Overall, DN showed increased accuracy compared to the freehanded technique and could be especially helpful in treating highly difficult endodontic cases. Clinical studies are needed to confirm the published in vitro data.
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Villa-Machado PA, Restrepo-Restrepo FA, Sousa-Dias H, Tobón-Arroyave SI. Application of computer-assisted dynamic navigation in complex root canal treatments: Report of two cases of calcified canals. AUST ENDOD J 2022; 48:187-196. [PMID: 35255155 DOI: 10.1111/aej.12614] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 01/13/2022] [Accepted: 02/13/2022] [Indexed: 12/18/2022]
Abstract
Root canal treatment and non-vital bleaching of teeth with pulp canal obliteration may represent a complex challenge to the clinician. This report describes the usefulness of the computer-assisted dynamic navigation system for the root canal treatment of two cases of teeth with a history of traumatic injury, extensively obliterated root canals and crown discoloration. Clinical and cone-beam computed tomographic evaluations were completed prior to procedures and 12 months after treatment. Both cases were treated using a computer-assisted dynamic navigation system coupled to a high-speed handpiece in order to establish the location and orientation of the partially obliterated canal and endodontic access route planning. The system allowed an accurate localisation of the root canal with a conservative access cavity. At the 12-month recall examination, the patients continue to be symptom-free, with a normal appearance of the mucogingival complex, adequate restoration of the tooth colour and intact periapical structures.
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Silva EJNL, De-Deus G, Souza EM, Belladonna FG, Cavalcante DM, Simões-Carvalho M, Versiani MA. Present status and future directions - Minimal endodontic access cavities. Int Endod J 2022; 55 Suppl 3:531-587. [PMID: 35100441 DOI: 10.1111/iej.13696] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/26/2022] [Accepted: 01/28/2022] [Indexed: 11/29/2022]
Abstract
In the last decades, the move of Medicine towards minimally invasive treatments is notorious and scientifically grounded. As Dentistry naturally follows its footsteps, minimal access preparation also became a trend topic in the endodontic field. This procedure aims to maximize preservation of dentine tissue, backed up by the idea that this is an effective way to reduce the incidence of post-treatment tooth fracture. However, with the assessment of the body of evidence on this topic, it is possible to observe some key-points (a) the demand for nomenclature standardization, (b) the requirement of specific tools such as ultra-flexible instruments, visual magnification, superior illumination, and three-dimensional imaging technology, (c) minimally invasive treatment does not seem to affect orifice location and mechanical preparation when using adequate armamentarium, but it (d) may impair adequate canal cleaning, disinfection, and filling procedures, and also (e) it displays contradictory results regarding the ability to increase the tooth strengthen compared to the traditional access cavity. In spite of that, it is undeniable that methodological flaws of some benchtop studies using extracted teeth may be responsible for the conflicting data, thus triggering the need for more sophisticated devices/facilities and specifically designed research in an attempt to make it clear the role of the access size/design on long-term teeth survival. Moreover, it is inevitable that a clinical approach like minimal endodontic access cavities that demands complex tools and skilled and experienced operators bring to the fore doubts on its educational impact mainly when confronted with the conflicting scientific output, ultimately provoking a cost-benefit analysis of its implementation as a routine technique. In addition, this review discusses the ongoing scientific and clinical status of minimally invasive access cavities aiming to input an in-depth and unbiased view over the rationale behind them, uncovering not only the related conceptual and scientific flaws, but also outlining future directions for research and clinical practices. The conclusions attempt to skip from passionate disputes highlighting the current body of evidence as weak and incomplete to guide decision making, demanding the development of a close-to-in-situ laboratory model or a large and well-controlled clinical trial to solve this matter.
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Affiliation(s)
- Emmanuel João Nogueira Leal Silva
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.,Department of Endodontics, School of Dentistry, Grande Rio University (UNIGRANRIO), Rio de Janeiro, Rio de Janeiro, Brazil
| | - Gustavo De-Deus
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
| | - Erick Miranda Souza
- Department of Dentistry II, Federal University of Maranhão, São Luís, Maranhão
| | | | | | - Marco Simões-Carvalho
- Department of Endodontics, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil
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Mujumdar S, Borkar A, Maral S, Nighot N, Aras S. Use of dynamic navigation system in endodontics: A literature review. J Int Clin Dent Res Organ 2022. [DOI: 10.4103/jicdro.jicdro_57_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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21
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Connert T, Leontiev W, Dagassan-Berndt D, Kühl S, ElAyouti A, Krug R, Krastl G, Weiger R. Real-Time Guided Endodontics with a Miniaturized Dynamic Navigation System Versus Conventional Freehand Endodontic Access Cavity Preparation: Substance Loss and Procedure Time. J Endod 2021; 47:1651-1656. [PMID: 34310979 DOI: 10.1016/j.joen.2021.07.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/15/2021] [Accepted: 07/15/2021] [Indexed: 12/18/2022]
Abstract
INTRODUCTION This study aimed to evaluate substance loss and the time required for access cavity preparation (ACP) using the conventional freehand method (CONV) versus a miniaturized dynamic navigation system of real-time guided endodontics (RTGE) in an in vitro model using 3-dimensional-printed teeth. METHODS Nine human anterior maxillary teeth were selected and micro-computed tomographic scanned. Root canals were virtually reduced to 2 mm below the cementoenamel junction. The teeth were digitally duplicated and mirrored to yield 6 different models with 6 single-rooted teeth each. The models were 3-dimensionally printed using radiopaque resin and consecutively mounted on a dental mannequin for ACP. Two operators with 12 and 2 years of clinical experience, respectively, received 6 models (36 teeth) each and performed ACP on half of the models using RTGE (after digital planning) and CONV on the other half 2 weeks later. The time was recorded. Postoperative substance loss was measured by cone-beam computed tomographic imaging. The differences in time and substance loss between the methods and operators were evaluated by the t test. RESULTS Overall, substance loss was significantly lower with RTGE than CONV (mean = 10.5 mm3 vs 29.7 mm3), but both procedures took a similar time per tooth (mean = 195 vs 193 seconds). Operator 1 (more experienced) achieved significantly less substance loss than operator 2 with CONV (mean = 19.9 vs 39.4 mm3) but not with RTGE (mean = 10.3 vs 10.6 mm3). CONCLUSIONS RTGE is a practicable, substance-sparing method performed in comparable time as CONV. Moreover, RTGE seems to be independent of operator experience.
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Affiliation(s)
- Thomas Connert
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland.
| | - Wadim Leontiev
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Dorothea Dagassan-Berndt
- Center for Dental Imaging, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Sebastian Kühl
- Department of Oral Surgery, University Center for Dental Medicine, University of Basel, Basel, Switzerland
| | - Ashraf ElAyouti
- Division of Endodontology, Department of Conservative Dentistry, School of Dental Medicine, University of Tübingen, Tübingen, Germany
| | - Ralf Krug
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Gabriel Krastl
- Department of Conservative Dentistry and Periodontology, University Hospital of Würzburg, Würzburg, Germany
| | - Roland Weiger
- Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine, University of Basel, Basel, Switzerland
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22
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Janabi A, Tordik PA, Griffin IL, Mostoufi B, Price JB, Chand P, Martinho FC. Accuracy and Efficiency of 3-dimensional Dynamic Navigation System for Removal of Fiber Post from Root Canal-Treated Teeth. J Endod 2021; 47:1453-60. [PMID: 34265326 DOI: 10.1016/j.joen.2021.07.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/24/2021] [Accepted: 07/01/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION The purpose of this study was to investigate the accuracy and efficiency of the 3-dimensional dynamic navigation system (DNS) compared with the freehand technique (FH) when removing fiber posts from root canal-treated teeth. METHODS Twenty-six maxillary teeth were included. Teeth were root canal treated and restored with Parapost Taper Lux (Coltene/Whaledent, Altstätten, Switzerland) luted with RelyX Unicem (3M ESPE, St Paul, MN). A core buildup was then performed using Paracore (Coltene/Whaledent). Teeth were mounted in tissue-denuded cadaver maxillae. Teeth were divided into 2 groups: the DNS group (n = 13) and the FH group (n = 13). Cone-beam computed tomographic scans were taken pre- and postoperatively. The drilling path and depth were planned virtually using X-guide software (X-Nav Technologies, Lansdale, PA) in both groups. For the DNS group, drilling was guided with X-Nav software and the FH group under a dental operating microscope. Global coronal and apical deviations, angular deflection, operation time, and the number of mishaps were compared between the groups to determine the accuracy and efficiency. The 3-dimensional volume (mm3) of all teeth was calculated before and after post removal using the Mimics Innovation Suite (Materialise NV, Leuven, Belgium). The Shapiro-Wilk, 1-way analysis of variance, and Fisher exact tests were used (P < .05). RESULTS The DNS group showed significantly less global coronal and apical deviations and angular deflection than the FH group (P < .05). DNS required less operation time than FH. Moreover, the DNS technique had significantly less volumetric loss of tooth structure than the FH technique (P < .05). CONCLUSIONS The DNS was more accurate and efficient in removing fiber posts from root canal-treated teeth than the FH technique.
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23
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Dianat O, Nosrat A, Mostoufi B, Price JB, Gupta S, Martinho FC. Accuracy and efficiency of guided root-end resection using a dynamic navigation system: a human cadaver study. Int Endod J 2021; 54:793-801. [PMID: 33368371 DOI: 10.1111/iej.13466] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/19/2020] [Accepted: 12/22/2020] [Indexed: 12/17/2022]
Abstract
AIM To determine and compare the accuracy and efficiency of a dynamic navigation system (DNS) with a freehand (FH) technique when conducting root-end resection in a human cadaver model. METHODOLOGY Forty roots in cadaver heads were included and divided into two groups: DNS (n = 20) and FH (n = 20). Cone beam computed tomography (CBCT) scans of all teeth were taken. The drilling path and depth were planned virtually to using the X-guide software (X-Nav Technologies, Lansdale, PA, USA). Osteotomy and root-end resection were done under navigation in the DNS group, and freehand under the dental operating microscope in the FH group. Post-operative CBCTs were taken. Linear deviations, angular deflection, time of operation and number of mishaps were compared with determine the accuracy and efficiency. Shapiro-Wilk, one-way ANOVA and Fisher exact tests were used (P < 0.05). RESULTS Linear deviations, angular deflection and operation time were significantly less in the DNS group (P < 0.05). The number of mishaps was not different between the two groups (P > 0.05). Subgroup analyses revealed that the distance of >5 mm from buccal cortical plate was significantly associated with lower accuracy, increased operation time and greater incidence of mishaps in the FH group (P < 0.05), but not in the DNS group. CONCLUSIONS The dynamic navigation system was more accurate and more efficient in root-end resection in a cadaver model than the freehand technique. The distance of the roots from the buccal cortical plate had a significant negative impact on the accuracy and efficacy of the root-end resection procedure when using the freehand technique. The dynamic navigation system has the potential to be a safe and reliable technological addition to endodontic microsurgery.
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Affiliation(s)
- O Dianat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - A Nosrat
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - B Mostoufi
- Department of Oral & Maxillofacial Surgery, University of Maryland, Baltimore, Maryland, USA
| | - J B Price
- Department of Oncology & Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland, USA
| | - S Gupta
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
| | - F C Martinho
- Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland, USA
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24
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Aminoshariae A, Azarpazhooh A, Diogenes AR, Fouad AF, Glickman GN, Kishen A, Letra AM, Levin L, Roda RS, Setzer FC, Tay FR, Hargreaves KM. Insights into the April 2021 Issue of the Journal of Endodontics. J Endod 2021; 47:555-557. [PMID: 33662436 DOI: 10.1016/j.joen.2021.02.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Anibal R Diogenes
- University of Texas Health San Antonio School of Dentistry, San Antonio, Texas
| | | | | | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Ariadne M Letra
- University of Texas Health Science Center at Houston School of Dentistry, Houston, Texas
| | | | | | - Frank C Setzer
- Diplomate, American Board of Endodontics; Assistant Professor, Clinic & Predoctoral Program and Director, Department of Endodontics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Franklin R Tay
- The Dental College of Georgia, Augusta University, Augusta, Georgia
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