Accuracy and Efficiency of 3-dimensional Dynamic Navigation System for Removal of Fiber Post from Root Canal-Treated Teeth

Anmar Janabi; Patricia A Tordik; Ina L Griffin; Behzad Mostoufi; Jeffey B Price; Priya Chand; Frederico C Martinho

doi:10.1016/j.joen.2021.07.002

Accuracy and Efficiency of 3-dimensional Dynamic Navigation System for Removal of Fiber Post from Root Canal-Treated Teeth

J Endod. 2021 Sep;47(9):1453-1460. doi: 10.1016/j.joen.2021.07.002. Epub 2021 Jul 13.

Authors

Anmar Janabi¹, Patricia A Tordik¹, Ina L Griffin¹, Behzad Mostoufi², Jeffey B Price³, Priya Chand¹, Frederico C Martinho⁴

Affiliations

¹ Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland.
² Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, Maryland.
³ Department of Oncology and Diagnostic Sciences, School of Dentistry, University of Maryland, Baltimore, Maryland.
⁴ Division of Endodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland, Baltimore, Maryland. Electronic address: fmartinho@umaryland.edu.

PMID: 34265326
DOI: 10.1016/j.joen.2021.07.002

Abstract

Introduction: The purpose of this study was to investigate the accuracy and efficiency of the 3-dimensional dynamic navigation system (DNS) compared with the freehand technique (FH) when removing fiber posts from root canal-treated teeth.

Methods: Twenty-six maxillary teeth were included. Teeth were root canal treated and restored with Parapost Taper Lux (Coltene/Whaledent, Altstätten, Switzerland) luted with RelyX Unicem (3M ESPE, St Paul, MN). A core buildup was then performed using Paracore (Coltene/Whaledent). Teeth were mounted in tissue-denuded cadaver maxillae. Teeth were divided into 2 groups: the DNS group (n = 13) and the FH group (n = 13). Cone-beam computed tomographic scans were taken pre- and postoperatively. The drilling path and depth were planned virtually using X-guide software (X-Nav Technologies, Lansdale, PA) in both groups. For the DNS group, drilling was guided with X-Nav software and the FH group under a dental operating microscope. Global coronal and apical deviations, angular deflection, operation time, and the number of mishaps were compared between the groups to determine the accuracy and efficiency. The 3-dimensional volume (mm³) of all teeth was calculated before and after post removal using the Mimics Innovation Suite (Materialise NV, Leuven, Belgium). The Shapiro-Wilk, 1-way analysis of variance, and Fisher exact tests were used (P < .05).

Results: The DNS group showed significantly less global coronal and apical deviations and angular deflection than the FH group (P < .05). DNS required less operation time than FH. Moreover, the DNS technique had significantly less volumetric loss of tooth structure than the FH technique (P < .05).

Conclusions: The DNS was more accurate and efficient in removing fiber posts from root canal-treated teeth than the FH technique.

Keywords: Dynamic navigation system; endodontics; guided endodontics; mimics; post removal.

MeSH terms

Belgium
Cone-Beam Computed Tomography
Dental Pulp Cavity / diagnostic imaging
Dental Pulp Cavity / surgery
Post and Core Technique*
Root Canal Therapy
Tooth*