Targeted Endodontic Microsurgery: Trephine Bur and Endodontic Microsurgery Carbide Bur Root End Appearance after Resection in Porcine Teeth
Abstract
Aim: The introduction of stent-guided trephines in endodontic surgery has allowed clinicians precise and predictable osteotomy and root end resections, especially in anatomically challenging scenarios. While the effects of trephines on bone has been reported in dental literature, little information is available on the effect trephines have on dentin. This in situ animal study investigates and compares the surface appearance of root ends resected by highspeed Lindemann carbide burs and stent-guided slow speed trephine burs. Methodology: Contralaterally matched porcine blocks containing the second and third mandibular premolars were selected for this study. Pre-operative 40 x 40 mm Cone Beam Computed Tomography (CBCT) studies were taken for surgical preparation and fabrication of targeted endodontic microsurgery (TEMS) guides. A total of fifty-two mesial roots were divided into two groups; 26 roots received endodontic microsurgery (EMS) using a high-speed Lindemann bur, while the contralateral side received TEMS using a slow speed trephine. The burs were only used on one experimental block (two roots) and always started on the mesial root of the second premolar. The roots were analyzed under a surgical operating microscope and stereomicroscope for the presence of dentinal defects. Results: Of the 52 roots examined, 10 (19.23%) had dentinal defects. The TEMS group (n = 1, 3.85%) had a significantly lower number of roots with defects than the EMS group (n = 9, 34.62%) (p = 0.01). Additionally, there was no significant difference in the number of defects found between the first and second root resection with the same bur. Conclusions: This in situ study demonstrates that both Lindemann and trephine burs can be used multiple times without detrimental effects on dentin. More importantly, trephine root end resections create less dentinal defects when compared to root end resections performed by Lindemann burs on porcine teeth.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 17, 2020
- Accession Number
- AD1182682
Entities
People
- Allen M. Pratt
- Andrea L Dufour
- Jarom J. Ray
Organizations
- Uniformed Services University of the Health Sciences