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OR04 - Root-end Preparation and Root-end Fill in Minimally Invasive Osteotomy Using 3D Dynamic Navigation System

Thursday, April 28, 2022

10:40 AM – 10:50 AM PST

Location: 225

Presenter(s)

Sara A. Aldahmash, B.D.S.

Endodontic postgraduate resident
University of Maryland
University of Maryland Baltimore
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Co-Author(s)

OD

Omid Dianat, D.D.S., M.S.

Clinical Instructor
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
TC

Thomas Cahill, B.Sc.

Dental student
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
IG

Ina L. Griffin, D.M.D.

Director, Postgraduate Endodontics
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
BM

Behzad Mostoufi, D.D.S., M.D.S.

Director, Implant Surgery Program
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Jeffery B. Price, D.D.S., M.S.

Director of Oral Radiology
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.
Patricia A. Tordik, D.M.D.

Clinical Professor
University of Maryland
Baltimore, Maryland

Disclosure: Disclosure information not submitted.
FM

Frederico C. Martinho, D.D.S., Ph.D., M.Sc.

Director, Predoctoral Endodontics
University of Maryland
Baltimore, Maryland

Disclosure: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Abstract: Persistent apical periodontitis associated with previous endodontic treatment can be surgically managed. This research study introduces the use of a 3D dynamic navigation system (3D-DNS) to endodontic microsurgery. We evaluated the accuracy and efficiency of 3D-DNS to perform a minimally invasive ostectomy and investigated the viability of root-end preparation/filling in the same surgical site. Two fresh cadaver heads with 48 roots were divided into two experimental groups: 3D-DNS (n=24) and CBCT-approximated freehand technique (CBCT-FH) (n=24). A pre-operative CBCT scan assisted in surgical planning. The ostectomy/root-end resection in the 3D-DNS group was completed with X-Guide®(X-Nav Technologies, LLC, Lansdale, PA, USA). The CBCT-FH group was done by visually approximating measurements from the CBCT scan and dental operating microscope. In both groups, Class-I cavity root-end preparations (3mm) were made with ultrasonic surgical tips followed by root-end filling with EndoSequence® BC RRM™ (Brasseler USA® Savannah, GA). A second CBCT scan was taken to calculate the volume of ostectomies (mm3) using the Mimics Innovation Suite (Materialise NV, Leuven, Belgium). Shapiro-Wilks test verified normality. Comparison between groups was made using a t-test and the Pearson correlation coefficient. The 3D-DNS was more accurate, showing lower linear and angular deviations, less operation time, and significantly less volumetric bone removal than CBCT-FH (p < .05). Root-end preparation/fillings for all roots were successfully performed with minimally invasive ostectomy in both groups. The 3D-DNS was more accurate and efficient than CBCT-FH, revealing promising applications to the clinical practice of endodontic microsurgery.