背景:这项研究调查了一种新型钻孔方法的可行性,该方法将先导环钻整合到动态导航(DN)中,用于在牙髓显微外科(EMS)中进行引导截骨和根端切除(RER)和一次性手术。
方法:两名具有不同DN水平经验的操作员在3D打印颌骨模型上使用两种单向钻孔方法和DN辅助操作进行了引导截骨术和RER。方法1(M1)涉及用常规的环钻钻孔。方法2(M2)涉及用先导环钻钻探,然后用传统的环钻钻孔。准确性,时间,并对M1和M2的安全性进行了比较。精度测量包括平台偏差(PD),终点偏差(ED),角度偏差(AD),切除长度偏差(RLD),和切除斜角(RBA)。其他参数包括截骨手术时间和RER(OT)和bur滑脱数(SN)。统计分析采用双样本t检验或曼-惠特尼U检验,显著性水平设置为0.05。
结果:PD,AD,RBA,M2组的SN明显少于M1组(P<0.05)。对于M1,新算子(NO)表现出明显更高的PD值,ED,OT,和SN比经验丰富的运营商(EO)(P<0.05)。对于M2,NO仅表现出显著较高的ED值(P<0.05),钻孔深度>7mm与较长的OT显著相关(P<.05)。
结论:在这项手术模拟比较研究中,试点演习的结合提高了DN辅助EMS的准确性和安全性。
BACKGROUND: This study investigated the feasibility of a novel drilling approach that integrates a pilot trephine into dynamic navigation (DN) for guided osteotomy and root-end resection (RER) with unimanual operation in endodontic microsurgery.
METHODS: Two operators with varying levels of DN experience performed guided osteotomy and RER using 2 unimanual drilling methods with DN-aided operation on 3-dimensional printed jaw models. Method 1 (M1) involved drilling with a conventional trephine. Method 2 (M2) involved drilling with a pilot trephine, followed by drilling with a conventional trephine. Accuracy, time, and safety of M1 and M2 were compared. Accuracy measurements included platform deviation (PD), end deviation (ED), angular deviation (AD), resection length deviation (RLD), and resection bevel angle (RBA). Additional parameters included osteotomy and RER time (OT) and bur slippage number (BSN). Statistical analyses were conducted using a 2-sample t-test or Mann-Whitney U test, with the significance level set at .05.
RESULTS: The PD, AD, RBA, and BSN in the M2 group were significantly less than in the M1 group (P < .05). For M1, the novice operator (NO) exhibited significantly higher values of PD, ED, OT, and BSN than the experienced operator (EO) (P < .05). For M2, the NO exhibited significantly higher value of ED only (P < .05), and drilling depth >7 mm was significantly associated with a longer OT (P < .05).
CONCLUSIONS: In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided endodontic microsurgery.