华西口腔医学杂志 ›› 2022, Vol. 40 ›› Issue (1): 111-122.doi: 10.7518/hxkq.2022.01.017

• 方法介绍 • 上一篇    

数字化导板引导技术辅助微创治疗前牙钙化根管

高羽轩1(), 汪鎏1, 傅裕杰2, 杨帆1, 张岚1, 黄定明1()   

  1. 1.口腔疾病研究国家重点实验室 国家口腔疾病临床医学研究中心 四川大学华西口腔医院牙体牙髓病科,成都 610041
    2.同济大学口腔医学院和附属口腔医院牙体牙髓病科,上海 200072
  • 收稿日期:2020-11-13 修回日期:2021-10-20 出版日期:2022-02-01 发布日期:2022-02-07
  • 通讯作者: 黄定明 E-mail:598983916@qq.com;dingminghuang@163.com
  • 作者简介:高羽轩,硕士,E-mail:598983916@qq.com
  • 基金资助:
    四川省科技厅重点项目(2021YFS0031);四川大学华西口腔医院探索与研发项目(LCYJ2019-6)

Minimally invasive treatment of calcified root canals in anterior teeth with digital guide technique

Gao Yuxuan1(), Wang Liu1, Fu Yujie2, Yang Fan1, Zhang Lan1, Huang Dingming1()   

  1. 1.State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.Dept. of Cariology and Endodontics, School and Hospital of Stomatology, Tongji University, Shanghai 200072, China
  • Received:2020-11-13 Revised:2021-10-20 Online:2022-02-01 Published:2022-02-07
  • Contact: Huang Dingming E-mail:598983916@qq.com;dingminghuang@163.com
  • Supported by:
    Key Research and Development Program of Sichuan University(2021YFS0031);Research and Develop Program, West China Hospital of Stomatology, Sichuan University(LCYJ2019-6);Correspondence: Huang Dingming, E-mail: dingminghuang@163.com

摘要: 目的

结合数字化导板技术及微创车针,建立数字化导板技术引导微创治疗钙化根管的临床方法。

方法

对于根管影像部分消失的前牙钙化患者,进行锥形束计算机断层扫描(CBCT)及数字化口腔扫描。通过三维重建技术还原根管形态,精准确定钙化的位置、长度及方向。利用可视化通路设计软件结合三维打印技术进行数字化导板的设计及制作,微创车针在导板及套管系统引导下去除根管内钙化组织,完成根管治疗。

结果

2例患牙均成功完成开髓路径的建立。病例1开髓角度偏差为1.37°±0.07°,钻针基底部的偏差为0.08~0.81 mm,钻针根尖部的偏差为0.05~1.13 mm,牙体组织去除量的偏差为0.84~4.25 mm3。病例2开髓角度偏差为3.09°±0.12°,钻针基底部的偏差为0.09~0.68 mm,钻针根尖部的偏差为0.29~0.66 mm,牙体组织去除量的偏差为0.55~3.79 mm3

结论

数字化导板引导微创根管治疗技术可以在疏通根管内钙化组织的同时尽可能多地保留健康牙体组织,为患牙的长期留存提供保障。

关键词: 引导牙髓治疗, 微创牙髓治疗, 钙化根管, 数字化导板

Abstract: Objective

This study aims to establish a minimally invasive treatment using a customized digital template and a miniaturized bur for pulp canal obliteration (PCO).

Methods

Cone-beam computed tomography (CBCT) and digital oral scans of patients diagnosed with PCO in anterior teeth were obtained. Root canal morphology was reconstructed to accurately show the location, length, and direction of obliteration. A digital template was designed and fabricated using visual design software and 3D printing technology and used as guide for the miniaturized bur and drill sleeve during calcified tissue removal. A conventional root canal treatment was performed after the lumen of the root canal was reached.

Results

In both cases, the planned access cavity and glide paths were successfully established. In case 1, the deviated angle of the access cavity was 1.37°±0.07°, the deviation at the bottom of the miniaturized bur was 0.08-0.81 mm, the deviation at the tip of the bur was 0.05-1.13 mm, and difference in substance loss was 0.84-4.25 mm³. In case 2, the deviated angle of the access cavity was 3.09° ± 0.12°, the deviation at the bottom of the bur was 0.09-0.68 mm, the deviation at the tip of the bur was 0.29-0.66 mm, and the difference in substance loss was 0.55-3.79 mm3.

Conclusion

Micro-guided endodontics is a novel approach for localizing and negotiating obliterated root canals and guarantees long-term prognosis without requiring excessive hard tissue removal.

Key words: guided endodontics, minimally invasive endodontics, pulp canal obliteration, digital template

中图分类号: