Novel method for augmented reality guided endodontics: An in vitro study

Marco Farronato; Andres Torres; Mariano S Pedano; Reinhilde Jacobs

doi:10.1016/j.jdent.2023.104476

Novel method for augmented reality guided endodontics: An in vitro study

J Dent. 2023 May:132:104476. doi: 10.1016/j.jdent.2023.104476. Epub 2023 Mar 9.

Authors

Marco Farronato¹, Andres Torres², Mariano S Pedano³, Reinhilde Jacobs⁴

Affiliations

¹ Department of Biomedical, Surgical and Dental Sciences, School of Dentistry, University of Milan, 20100 Italy. Electronic address: marco.farronato@unimi.it.
² OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, Leuven, Belgium.
³ Department of Oral Health Sciences, Endodontology, University Hospitals Leuven, Leuven, Belgium.
⁴ OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium; Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium; Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden.

PMID: 36905949
DOI: 10.1016/j.jdent.2023.104476

Abstract

Objective: The aim of this study is to evaluate the accuracy in endodontics of a novel augmented reality (AR) method for guided access cavity preparation in 3D-printed jaws.

Methods: Two operators with different levels of experience in endodontics performed pre-planned virtually guided access cavities through a novel markerless AR system on three sets of 3D-printed jaw models (Objet Connex 350, Stratasys) mounted on a phantom. After the treatment, a post-operative high-resolution CBCT scan (NewTom VGI Evo, Cefla) was taken for each model and registered to the pre-operative model. All the access cavities were then digitally reconstructed by filling the cavity area using 3D medical software (3-Matic 15.0, materialize). For the anterior teeth and the premolars, the deviation at the coronal and apical entry points as well as the angular deviation of the access cavity were compared to the virtual plan. For the molars, the deviation at the coronal entry point was compared to the virtual plan. Additionally, the surface area of all access cavities at the entry point was measured and compared to the virtual plan. Descriptive statistics for each parameter were performed. A 95% confidence interval was calculated.

Results: A total of 90 access cavities were drilled up to a depth of 4 mm inside the tooth. The mean deviation in the frontal teeth and in the premolars at the entry point was 0.51 mm and 0.77 mm at the apical point, with a mean angular deviation of 8.5° and a mean surface overlap of 57%. The mean deviation for the molars at the entry point was 0.63 mm, with a mean surface overlap of 82%.

Conclusion: The use of AR as a digital guide for endodontic access cavity drilling on different teeth showed promising results and might have potential for clinical use. However, further development and research might be needed before in vivo validation.

Keywords: Augmented reality; Cone-beam computed tomography; Guided endodontics; Minimal invasive endodontics; Visual-inertial odometry.

MeSH terms

Augmented Reality*
Bicuspid
Cone-Beam Computed Tomography
Dental Caries*
Dental Pulp Cavity / diagnostic imaging
Endodontics* / methods
Humans