Targeted Endodontic Microsurgery and EMS: A Surgical Simulation Comparison

Abstract

Aim: Targeted Endodontic Microsurgery (TEMS) produces precise osteotomy site, angulation depth and diameter, in anatomically challenging scenarios. Trephine bur are targeted to resect bone and root ends to exacting 3DSG specifications predetermined within design software. A gap in knowledge exists in that the efficiency and capability of TEMS, as compared to endodontic microsurgery (EMS), for efficient and effective osteotomy and root resection (OR) has not been investigated. The purpose of this study is to compare surgical time, bevel angle and site volumetric profiles of OR accomplished by TEMS and traditional EMS in a surgical simulation model (SSM). Methodology: An 80x80 mm Cone Beam Computed Tomography (CBCT) file was imported into Mimics software where artificial periapical lesions were created encompassing twelve root apices. Maxillary and mandibular surgical simulation models (SSM) were printed. TEMS 3DSGs were designed and printed for each surgical site. Three board-certified endodontists used the original CBCT to plan and perform EMS on six maxillary and six mandibular teeth. Next, endodontists performed TEMS surgeries on duplicate SSM for the same teeth. All surgeries were timed. Post-operative CBCT images of SSMs were made and imported into Amira software for measurement of bevel angle and site volumetric profiles. Paired t-tests compared the mean differences between EMS and TEMS groups. A Bonferroni correction determined data to be significant at p<0.004. Results: TEMS reduced surgical time, had bevel angles more closely approaching zero degrees, and had significantly less volume and length of root resection. Conclusions: TEMS represents a viable alternative to EMS throughout the dentition, and particularly in anatomically challenging scenarios where damage to adjacent teeth can occur.

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Document Details

Document Type
Technical Report
Publication Date
Jun 30, 2019
Accession Number
AD1127891

Entities

People

  • Allen M. Pratt
  • James A. Wealleans
  • Jarom J. Ray
  • Tyler K. Hawkins

Organizations

  • Uniformed Services University of the Health Sciences

Tags

DTIC Thesaurus Topics

  • Additive Manufacturing
  • Data Processing
  • Fabrication
  • Information Science
  • Materials
  • Measurement
  • Methylene Blue
  • Microsurgery
  • New York
  • Printing
  • Redox Indicators
  • Simulations
  • South Carolina
  • Statistical Analysis
  • Surgery
  • Teeth
  • Therapy
  • Three Dimensional
  • Tomography
  • United States
  • Volume
  • X-Ray Computed Tomography

Fields of Study

  • Medicine

Readers

  • Battery Technology and Engineering
  • Computational Modeling and Simulation
  • Trauma Surgery or Emergency Medicine.