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Published on: May 5, 2022
Custom Sleeve Parameters in Static Guided Endodontic Access: Influence on Deviation Control in Pulp Canal
Anna Muryani1,2, Dudi Aripin2, Hendra Dian Adhita Dharsono2
1Doctoral Programme Faculty of Medicine, Universitas Padjadjaran, Bandung, West Java, Indonesia.
Static guided endodontic access (SGEA) with custom zirconia sleeves significantly improves accuracy over freehand access for treating pulp canal obliteration (PCO). A 7mm zirconia sleeve demonstrated the highest precision, reducing risks in endodontic procedures.
Area of Science:
- Endodontics
- Dental Materials Science
- Biomedical Engineering
Background:
- Pulp canal obliteration (PCO) presents significant challenges in endodontic treatment due to root canal narrowing.
- Conventional freehand access (FHA) in PCO cases increases the risk of iatrogenic errors.
- Static guided endodontic access (SGEA) offers a potential solution for precise root canal access.
Purpose of the Study:
- To evaluate the accuracy of static guided endodontic access (SGEA) using custom sleeves of varying materials and heights.
- To compare the precision of SGEA with conventional freehand access (FHA) in simulated pulp canal obliteration (PCO).
Main Methods:
- An in vitro study utilized 48 resin maxillary incisors with simulated PCO, created using CBCT, intraoral scanner, and 3D printing.
- Samples were divided into eight groups, including FHA, a titanium control, and six SGEA groups with custom Chrome-Cobalt (CoCr) and Zirconia sleeves at 3, 5, and 7 mm heights.
- Coronal and sagittal deviations were analyzed using CBCT scans, with statistical analysis via one-way ANOVA and Bonferroni tests.
Main Results:
- All SGEA groups showed significantly lower angular deviations than FHA (p < 0.05).
- The Zirconia 7 mm sleeve group exhibited the lowest mean coronal (1.83°) and sagittal (2.48°) deviations.
- Increased sleeve height enhanced angular precision, and Zirconia demonstrated superior dimensional stability over CoCr and Titanium.
Conclusions:
- SGEA technique significantly enhances accuracy in controlling drilling deviation compared to FHA for PCO.
- Custom 3D-printed Zirconia sleeves, particularly at 7 mm height, offer optimal precision for endodontic access in obliterated canals.
- Further in vivo validation is recommended for clinical application of SGEA in PCO treatment.
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