A Cadaver-based Comparison of Sleeve-guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections

Frederico C Martinho; Corey Rollor; Kyle Westbrook; Sara A Aldahmash; Guadalupe G Fay; Elias Rivera; Azin Parsa; Jeffery B Price; Patricia A Tordik

doi:10.1016/j.joen.2023.05.015

A Cadaver-based Comparison of Sleeve-guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections

J Endod. 2023 Aug;49(8):1004-1011. doi: 10.1016/j.joen.2023.05.015. Epub 2023 May 31.

Authors

Frederico C Martinho¹, Corey Rollor², Kyle Westbrook², Sara A Aldahmash², Guadalupe G Fay³, Elias Rivera³, Azin Parsa⁴, Jeffery B Price⁴, Patricia A Tordik²

Affiliations

¹ Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland. Electronic address: fmartinho@umaryland.edu.
² Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
³ Division of Prosthodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, School of Dentistry, Baltimore, Maryland.
⁴ Division of Oral Radiology, Department of Oncology and Diagnostic Sciences, University of Maryland, School of Dentistry, Baltimore, Maryland.

PMID: 37263496
DOI: 10.1016/j.joen.2023.05.015

Abstract

Introduction: This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER).

Methods: Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were planned virtually in the preoperative cone-beam computed tomography scan and guided using 3D-printed surgical guides in the FG sCAEMS and 3D-dynamic navigation system in the dCAEMS. The 2D and 3D deviations and angular deflection were calculated. The osteotomy volume, resected root length, and resection angle were measured. The osteotomy and RER time and the number of procedural mishaps were recorded.

Results: FG sCAEMS was as accurate as dCAEMS, with no difference in the 2D and 3D deviation values or angular deflection (P > .05). The osteotomy and RER time were shortened using FG sCAEMS (P < .05). The FG sCAEMS showed a greater number of incomplete RERs than dCAEMS. Osteotomy volume, RER angle, and root length resected were similar in both groups (P > .05). FG sCAEMS and dCAEMS were feasible for osteotomy and RER.

Conclusions: Within the limitations of this cadaver-based study, FG sCAEMS was as accurate as dCAEMS. Both FG sCAEMS and dCAEMS were time-efficient for osteotomy and RER.

Keywords: Dynamic navigation; endodontic; microsurgery; static navigation.

MeSH terms

Apicoectomy
Cadaver
Cone-Beam Computed Tomography
Dental Implants*
Humans
Osteotomy / methods
Surgery, Computer-Assisted*
Tooth*

Substances

Dental Implants