Real-time guided endodontics versus conventional freehand access cavity preparation by a specialist- an ex vivo comparative study.

IF 3.1 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Clinical Oral Investigations Pub Date : 2025-04-09 DOI:10.1007/s00784-025-06310-8

Hauke Hildebrand, Ralf Krug, Wadim Leontiev, Dorothea Dagassan-Berndt, Gabriel Krastl, Roland Weiger, Thomas Connert

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引用次数: 0

Abstract

Objectives: This study compared conventional access cavity preparation (CONV) and real-time guided endodontics (RTGE) in teeth with pulp canal calcification (PCC) regarding the rate of detected root canals, substance loss and procedural time.

Materials and methods: A total of 72 extracted, sound human teeth (48 incisors, 24 canines) with PCC were matched in pairs, divided into two groups of 36 teeth each. An endodontic specialist performed CONV, while a general dentist not specialized in endodontics utilized RTGE on six models each, under simulated clinical conditions. The operators recorded the time to access the calcified root canals. Pre- and postoperative cone-beam computed tomography (CBCT) scans were obtained to measure substance loss. Statistical significance was tested by examining the overlap of 95% confidence intervals (CIs) and Fisher's exact test.

Results: RTGE had a marginally higher success rate (34/36) in detecting root canals compared to CONV (32/36) (p =.67). While RTGE resulted in less substance loss (CI: 9-14.3 mm³ vs. 15-24.2 mm³), it required more procedural time than CONV (CI: 11.6-17.8 min vs. 1.4-2.5 min).

Conclusions: Both CONV by a specialist and RTGE by a general dentist achieved a high detection rate of root canals, with RTGE resulting in superior tooth substance preservation but at the expense of longer operation times.

Clinical relevance: RTGE can be considered as an alternative technique for non-specialists when treating teeth with PCC, emphasizing procedural safety and effective canal detection.

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实时引导的牙髓治疗与传统的专家徒手通道预备-一项离体比较研究。

目的：比较常规通道预备（CONV）和实时引导根管治疗（RTGE）对牙髓管钙化（PCC）的根管检出率、物质损失和手术时间。材料与方法：将72颗拔出的健康人牙（48颗门牙，24只犬齿）与PCC配对，分为两组，每组36颗牙。在模拟临床条件下，一名牙髓专科医生进行了CONV，而一名非牙髓专科的普通牙医分别对6个模型进行了RTGE。操作者记录了进入钙化根管的时间。术前和术后采用锥形束计算机断层扫描（CBCT）测量物质损失。通过检验95%置信区间（ci）的重叠和Fisher确切检验来检验统计显著性。结果：RTGE检测根管的成功率（34/36）略高于CONV (32/36) （p = 0.67）。虽然RTGE导致较少的物质损失（CI: 9-14.3 mm3 vs. 15-24.2 mm3），但它比CONV需要更多的手术时间（CI: 11.6-17.8 min vs. 1.4-2.5 min）。结论：专家CONV和普通牙医RTGE均能获得较高的根管检出率，RTGE能更好地保存牙物质，但需要更长的手术时间。临床意义：RTGE可作为非专业人员在PCC治疗牙齿时的替代技术，强调手术安全性和有效的根管检测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Oral Investigations 医学-牙科与口腔外科

CiteScore

6.30

自引率

5.90%

发文量

484

审稿时长

3 months

期刊介绍： The journal Clinical Oral Investigations is a multidisciplinary, international forum for publication of research from all fields of oral medicine. The journal publishes original scientific articles and invited reviews which provide up-to-date results of basic and clinical studies in oral and maxillofacial science and medicine. The aim is to clarify the relevance of new results to modern practice, for an international readership. Coverage includes maxillofacial and oral surgery, prosthetics and restorative dentistry, operative dentistry, endodontics, periodontology, orthodontics, dental materials science, clinical trials, epidemiology, pedodontics, oral implant, preventive dentistiry, oral pathology, oral basic sciences and more.