{"title":"A novel sleeveless guided system for reducing thermal injury in endodontic microsurgery with enhanced accuracy and efficiency.","authors":"Moran Jin, Rentao Tang, Zeqian Pan, Yuhan Wang, Zuhua Wang, Bing Han, Xiaoyan Wang","doi":"10.1007/s00784-025-06433-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated surgical temperature, accuracy, and efficiency in endodontic microsurgery (EMS) using the sleeveless guided system.</p><p><strong>Materials and methods: </strong>Sleeveless and sleeve guided systems were fabricated. Thermocouples were used to measure temperature changes during guided preparation in models (n = 5) featuring bone blocks installed in anterior, premolar, and molar regions. 72 teeth in 6 EMS models used for simulating the clinical scenario of endodontic microsurgery were equally randomized into 6 groups by guide type (sleeveless/sleeve/freehand) and operator experience, with each group containing matched dentition (2 anterior/2 premolar/2 molar teeth per arch; n = 12). Preoperative and postoperative models were superimposed using 3-matic Medical evaluate preparation accuracy, with surgical duration compared for efficiency. Temperature data were analyzed via t-test; accuracy and efficiency were assessed using two-way ANOVA.</p><p><strong>Results: </strong>The sleeveless guided system demonstrated significantly lower surgical area temperatures than the sleeve guided system (P < 0.001). Compared to freehand, it reduced three-dimensional (3D) deviation by 1.14 mm (52.8%), angular deviation by 4.06° (49.6%), and surgical time by 40.5 s (P < 0.05). When using sleeveless system, experienced operators exhibited reductions of 0.65 mm in 3D deviation and 4.51° in angular deviation, whereas inexperienced operators demonstrated larger reductions of 1.96 mm and 5.79° respectively. No significant differences were observed between guide systems in accuracy or efficiency (P > 0.05).</p><p><strong>Conclusion: </strong>The sleeveless guided system effectively reduces heat generation and enhances surgical accuracy and efficiency compared to freehand techniques significantly, with performance comparable to the sleeve guided system.</p><p><strong>Clinical relevance: </strong>The sleeveless guided system demonstrates promising applications in EMS.</p>","PeriodicalId":10461,"journal":{"name":"Clinical Oral Investigations","volume":"29 7","pages":"347"},"PeriodicalIF":3.1000,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Oral Investigations","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00784-025-06433-y","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study evaluated surgical temperature, accuracy, and efficiency in endodontic microsurgery (EMS) using the sleeveless guided system.
Materials and methods: Sleeveless and sleeve guided systems were fabricated. Thermocouples were used to measure temperature changes during guided preparation in models (n = 5) featuring bone blocks installed in anterior, premolar, and molar regions. 72 teeth in 6 EMS models used for simulating the clinical scenario of endodontic microsurgery were equally randomized into 6 groups by guide type (sleeveless/sleeve/freehand) and operator experience, with each group containing matched dentition (2 anterior/2 premolar/2 molar teeth per arch; n = 12). Preoperative and postoperative models were superimposed using 3-matic Medical evaluate preparation accuracy, with surgical duration compared for efficiency. Temperature data were analyzed via t-test; accuracy and efficiency were assessed using two-way ANOVA.
Results: The sleeveless guided system demonstrated significantly lower surgical area temperatures than the sleeve guided system (P < 0.001). Compared to freehand, it reduced three-dimensional (3D) deviation by 1.14 mm (52.8%), angular deviation by 4.06° (49.6%), and surgical time by 40.5 s (P < 0.05). When using sleeveless system, experienced operators exhibited reductions of 0.65 mm in 3D deviation and 4.51° in angular deviation, whereas inexperienced operators demonstrated larger reductions of 1.96 mm and 5.79° respectively. No significant differences were observed between guide systems in accuracy or efficiency (P > 0.05).
Conclusion: The sleeveless guided system effectively reduces heat generation and enhances surgical accuracy and efficiency compared to freehand techniques significantly, with performance comparable to the sleeve guided system.
Clinical relevance: The sleeveless guided system demonstrates promising applications in EMS.
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.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
