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Guided Access Cavity Preparation Using a New Simplified Digital Workflow.

Gustavo S Chaves1, Julio A Silva2, Lucas R Capeletti2

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Summary

A simplified digital workflow using cone-beam computed tomographic (CBCT) scans precisely guided root canal access in extracted molars, even with coronal restorations. This method proved as accurate as traditional CBCT and 3D oral scanning workflows.

Keywords:
3-dimensional printingcomputer-aided designcone-beam computed tomographyendodontics

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Area of Science:

  • Dentistry
  • Endodontics
  • Digital Imaging

Background:

  • Traditional root canal access relies on conventional methods.
  • Digital workflows offer potential for improved precision and efficiency.
  • Cone-beam computed tomography (CBCT) provides detailed 3D imaging for dental applications.

Purpose of the Study:

  • To evaluate the precision of a simplified digital workflow for guided root canal access in extracted mandibular molars.
  • To compare the precision of a CBCT-only workflow against a reference workflow using CBCT and 3D oral scanning.
  • To assess the impact of coronal restorations on the simplified CBCT-only workflow's precision.

Main Methods:

  • Forty-five extracted mandibular molars were divided into three groups: control (CBCT + 3D oral scan), experimental 1 (CBCT-only, no restoration), and experimental 2 (CBCT-only, with restoration).
  • Digital planning was performed using CBCT scans.
  • Access cavities were prepared using guides, and precision was measured by comparing planned and prepared cavities (deviation in millimeters and angle) using pre- and postoperative CBCT scans.

Main Results:

  • All root canals were successfully accessed in all groups.
  • Low deviations were observed: mean values ranged from 0.47 to 0.58 mm and 1.43° to 2.45° across groups.
  • No statistically significant differences in precision were found among the control, experimental 1, and experimental 2 groups.

Conclusions:

  • A simplified digital workflow utilizing only CBCT scans achieves high precision for root canal access in extracted molars.
  • The CBCT-only workflow demonstrated comparable precision to a workflow incorporating 3D oral scanning.
  • The presence or absence of coronal restorations did not significantly affect the precision of the simplified CBCT-only workflow.