Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (6): 731-736.doi: 10.7518/gjkq.2022104

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Application of computer-aided technology in fiber post removal

Cai Pingping(),Zhuo Yingying,Lin Jie,Zheng Zhi-qiang.()   

  1. Dept. of VIP Dental Service, Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
  • Received:2022-01-25 Revised:2022-05-14 Online:2022-11-01 Published:2022-11-03
  • Contact: Zhi-qiang. Zheng E-mail:903040951@qq.com;oliverzq@hotmail.com
  • Supported by:
    Natural Science Foundation of Fujian Province(2021J01796)

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Abstract:

With the gradual development of “Guided endodontics” in the field of endodontics, dynamic navigation system and digital surgical guide have also been applied to remove the fiber post in clinical. Compared with the current fiber post removal systems, the computer-aided removal methods are accurate, efficient, and minimally invasive. This article reviews the clinical application, advantages and disadvantages of various fiber post removal methods, analyzes the accuracy and error factors of computer-aided technology in fiber post removal, and provides reference for the operations to clinicians.

Key words: digital surgical guide, dynamic navigation system, fiber post removal, accuracy, error analysis

CLC Number: 

  • R 783.4

TrendMD: 

Fig 1

Clinical process of the two computer-aided technologies in fiber post removal"

Tab 1

Advantages and disadvantages of the different fiber post removal methods"

方式优点缺点
传统方式

机械

钻头

拆除

套装

1）相较于超声波和钻头，拆除速度快；2）拆除后没有改变牙体抗断裂性1）相较于超声波和钻头，拆除后根管壁上剩余材料量多；2）根管壁上微裂纹产生；3）仅适用于特定的桩系统
钻头1) 相较于拆除套装，拆除后根管壁上剩余材料量少；2）拆除后对根尖微裂缝的形成和扩散没有影响1）去除牙体组织多，侧向穿孔发生率高；2）相较于拆除套装，拆除时间长；3）拆除时间和有效性受操作员经验的显著影响
超声波相较于拆除套装，拆除后根管壁上剩余材料量少1）相较于拆除套装，去除牙体组织多；拆除时间长；2）拆除时间和有效性受操作员经验的显着影响；3）相较于未被移除或者拆除套装，拆除后牙体断裂阻力值显著降低

计算机

辅助技术

导板1）高精度，将钻头精确地保持在桩的轴线上；2）拆除速度快；3) 微创，去除牙体组织少；4) 降低技术敏感性，无需学习周期1）数据采集、设计制作及应用中的任何误差都会影响准确性；2）咬合空间有限的区域难以应用；3）冲洗困难、无法顺利排出碎屑；4）缺乏3D 实时可视化，不允许术中改变钻头轨迹
导航1）相较于传统方式，高精度、偏差小；拆除速度快；微创、去除牙体组织少；2）相较于导板，咬合空间有限的区域可以使用；3D实时可视化，允许术中改变钻头轨迹；易于冲洗，降低过热风险1）数据采集、设备应用中的任何误差都会影响准确性；2）手术区同颌对侧无牙或重度松动者难以应用；3）成本高、附件笨重和设置繁琐；4）需要学习周期，操作成功取决于操作者的熟练程度

Tab 2

Main sources of error of the two computer-aided technologies in fiber post removal"

方式误差类型
数据误差技术误差人为误差
数字化导板技术1）CBCT数据的采集1）不同导板设计软件1）患者的开口度
2）口内数字化印模过程2）3D打印设备和打印材料2）操作者的视野受阻
3）导板的就位情况
动态导航技术1）CBCT数据的采集1）不同动态导航系统软件1）患者的配合程度
2）口内数字化印模过程2）跟踪定位系统2）操作者的熟练程度
3）配准方式及配准过程
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