基于荧光的牙髓治疗牙根管再通路方法：MicroCT 三维评估。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics Pub Date : 2024-10-01 DOI:10.1016/j.joen.2024.07.009

Iago Ramirez DDS, MSc , Lautaro Gallardo Altube DDS, MSc , Rafael Verardino Camargo DDS, MSc , Alice Corrêa Silva-Sousa DDS, MSc, PhD , Aline Evangelista Souza-Gabriel DDS, MSc, PhD , Liviu Steier DDS, MSc, PhD , Fabiane Carneiro Lopes-Olhê DDS, MSc, PhD , Manoel Damião Sousa-Neto DDS, MSc, PhD , Jardel Francisco Mazzi-Chaves DDS, MSc, PhD

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引用次数: 0

摘要

目的：利用三维显微CT形态计量分析法，借助不同的放大方法，评估牙髓治疗下颌磨牙在去除美观修复冠套和牙颈部屏障后的牙本质去除量和修复材料残留量：方法：取样 30 颗下颌第一磨牙（n=30）。方法：使用 30 颗下颌第一磨牙样本（n=30），所有牙齿均经过牙髓治疗，标本在 MicroCT 中进行了初步扫描和重建。臼齿采用单锥技术充填，并立即去除最初 2 毫米颈水平的材料。使用添加了 0.1%荧光素的离子玻璃粘固剂制作牙颈部屏障，充填牙颈部 2 毫米的牙槽，并以另外 2 毫米作为基底。冠状修复使用美学树脂复合材料。模拟牙齿老化过程的热循环次数为 20,000 次。将样本分为三组（n=10），根据放大辅助工具，用金刚石车针去除修复体和牙颈部屏障：无放大辅助设备（肉眼）；手术显微镜辅助设备；REVEAL™ 设备辅助设备。取出后，以与初始扫描相同的参数进行最终 3D MicroCT 扫描和重建，并对最终扫描和初始扫描进行叠加。使用 CTAn 进行形态计量分析，以评估残余修复材料的体积（立方毫米）、牙本质去除体积（立方毫米）以及牙本质去除的方向和部位。数据采用单向方差分析（pResults：REVEAL™ 组在残余材料量（3.17 ± 1.65）和牙本质去除率（2.56 ± 1.34）方面表现更好。显微镜组与 REVEAL™ 组在牙本质去除率（3.30 ± 1.48）方面没有统计学差异，在残余材料量（9.63 ± 4.33）方面与裸眼组在统计学上相似。裸眼组的残余材料量（7.60 ± 2.68）和牙本质去除百分比（6.60 ± 3.70）结果最差：结论：使用荧光和放大镜的方法效果最好，牙本质去除率较低，剩余修复材料较少。这是牙髓病学中的一项创新技术，它显示出在牙髓再治疗中克服根管再通路挑战的潜力。

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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A Fluorescence-based Method to Reaccess Root Canals in Endodontically Treated Teeth: A Micro–Computed Tomography Tridimensional Assessment

Introduction

The aim of this study was to evaluate the volume of dentin removal and the volume of remnants of restorative material after the removal of an esthetic restorative coronal set and cervical barrier in endodontically treated mandibular molars with the aid of different magnification methods using 3-dimensional (3D) micro–computed tomographic (micro-CT) morphometric analysis.

Methods

A sample of 30 mandibular first molars (N = 30) was used. All teeth were endodontically treated, and the specimens were initially scanned using micro-CT imaging and reconstructed. The molars were filled by a single-cone technique, and immediately the material at the initial 2-mm cervical level was removed. Cervical barriers were confected using ionomer glass cement with fluorescein 0.1%, filling the 2 mm at the cervical level of the canals and an additional 2 mm as the base. The coronal restoration set was performed using esthetic resin composites. A simulated tooth aging process was performed with 20,000 thermocycling cycles. The sample was distributed into the following 3 groups (n = 10) for the removal of the restoration set and cervical barrier with diamond burs based on the magnification aid: no magnification aid (naked eye), operative microscope aid, and REVEAL device (Design for Vision Inc, Bohemia, NY) aid. After removal, the final 3D micro-CT scanning and reconstruction were conducted with the same parameters as the initial scanning, and superposition of the final and initial scanning was performed. Morphometric analysis was conducted using CTAn software (Bruker microCT, Kontich, Belgium) to assess the volume of remnant restorative material (mm³), the volume of dentin removal (mm³), and the direction and site of dentin removal. Data were analyzed using 1-Way analysis of variance (P < .05).

Results

The REVEAL group showed better results regarding the volume of remnant material (3.17 ± 1.65) and the percentage of dentin removal (2.56 ± 1.34). The microscope group showed no statistical difference compared with the REVEAL group regarding dentin removal (3.30 ± 1.48) and was statistically similar to the naked eye group in the volume of remnant material (9.63 ± 4.33). The naked eye group showed the worst results for the volume of remnant material (7.60 ± 2.68) and the percentage of dentin removal (6.60 ± 3.70).

Conclusions

The use of fluorescence associated with magnification was the method that presented the best results, with lower percentages of dentin removal and smaller volumes of remaining restorative material. This is an innovative technology in endodontics that shows potential to overcome the challenge of reaccessing root canals in the context of endodontic retreatment.

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来源期刊

Journal of endodontics 医学-牙科与口腔外科

CiteScore

8.80

自引率

9.50%

发文量

224

审稿时长

42 days

期刊介绍： The Journal of Endodontics, the official journal of the American Association of Endodontists, publishes scientific articles, case reports and comparison studies evaluating materials and methods of pulp conservation and endodontic treatment. Endodontists and general dentists can learn about new concepts in root canal treatment and the latest advances in techniques and instrumentation in the one journal that helps them keep pace with rapid changes in this field.