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A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Fibre Post Removal Using Dynamic Navigation System and Autonomous Robotic System: An In Vitro Study
Zhiming Cui1, Guangdao Zhang2, Bo Lv1
1Department of Endodontics, School and Hospital of Stomatology, China Medical University, Liaoning Provincial Key Laboratory of Oral Diseases, Shenyang, China.
Aim:
To evaluate and compare the efficiency, dentine preservation and accuracy of the dynamic navigation system (DNS) and autonomous robotic system (ATR) techniques against the conventional microscope-assisted ultrasonic (MU) technique for fibre post removal.
Methodology:
Sixty anatomically identical 3D-printed maxillary premolars were endodontically treated, received fibre posts and were randomly assigned to three groups (n = 20) for post removal: DNS, ATR and MU. In the DNS and ATR groups, initial removal was performed using a high-speed fissure bur guided by the respective system, followed by microscopic ultrasound to eliminate residual material. The MU group employed conventional microscope-assisted ultrasound throughout. Operative time was recorded, dentine loss and path deviation were assessed through pre- and post-operative CBCT analyses. Data were analyzed using one-way ANOVA or Kruskal-Wallis H test with appropriate post hoc multiple-comparison tests. A two-tailed p < 0.05 was considered statistically significant.
Results:
All posts were successfully removed without perforation. The ATR group demonstrated the shortest operative time (14 min 02 s ± 1 min 44 s), followed by DNS (21 min 26 s ± 2 min 40 s), and MU (24 min 41 s ± 2 min 46 s), with significant differences between each pair of groups (p < 0.05). Dentine loss was significantly lower in both DNS (0.24 ± 0.04 mm) and ATR (0.25 ± 0.03 mm) groups compared to the MU group (0.32 ± 0.04 mm) (p < 0.05), with no significant difference between DNS and ATR. At the apical and middle root levels, DNS and ATR caused significantly less dentine loss than MU. No significant differences in overall path deviation were observed among the groups.
Conclusion:
Within the limitations of this in vitro study using 3D-printed premolars, both DNS and ATR systems demonstrated superior efficiency and dentine preservation compared to the conventional MU technique for fibre post removal, with comparable accuracy-positioning them as promising alternatives. However, these findings warrant further validation using cadaveric or extracted human teeth with varied anatomies, as well as comparative assessments of thermal and cutting behaviour.
