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A Novel Robot-Assisted Access in Endodontic Microsurgery Combined with Sinus Floor Elevation for Maxillary First
Weiwei Qiao1, Li Qin1, Chen Chen1
1State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China; Department of Cariology and Endodontics, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
This study introduces an autonomous robotic system for minimally invasive endodontic microsurgery (EMS) on maxillary molars. This innovative approach enhances precision, especially when the maxillary sinus floor is close to the root apex, improving patient outcomes.
Area of Science:
- Dentistry
- Surgical Technology
- Endodontics
Background:
- Endodontic microsurgery (EMS) is crucial for treating endodontic disease post-nonsurgical failure.
- Maxillary molar EMS is challenging due to proximity to the maxillary sinus floor, risking membrane perforation.
- Root apex proximity to the buccal cortical plate limits visualization and instrument access during EMS.
Purpose of the Study:
- To report the first use of an autonomous robotic system for minimally invasive EMS on a maxillary first molar.
- To demonstrate precise lateral wall sinus fenestration combined with robotic assistance.
- To address the challenges of EMS in cases with a descended maxillary sinus floor.
Main Methods:
- An autonomous robotic system integrated cone-beam computed tomography (CBCT) and intraoral scan data.
- The system performed guided sinus fenestration localization, autonomous osteotomy, and root-end resection with real-time monitoring.
- Endoscopic assistance verified sinus membrane integrity, and root-end procedures were done microscopically.
Main Results:
- The robotic system enabled precise root-end resection and sinus fenestration in a challenging maxillary molar case.
- Real-time monitoring of depth, angulation, and force ensured procedural accuracy.
- Post-operative follow-ups showed an absence of clinical symptoms at 6 months.
Conclusions:
- Autonomous robotic systems offer a precise and minimally invasive solution for endodontic microsurgery on maxillary molars.
- This technology is particularly beneficial in cases involving a descended maxillary sinus floor.
- The combined approach enhances safety and efficacy in complex endodontic microsurgery cases.
