Date of Award

2019

Document Type

Thesis

Degree Name

Master of Science (MS)

Department

Oral Rehabilitation

College

College of Dental Medicine

First Advisor

Zachary Evans

Second Advisor

Theodore D. Ravenel V.

Third Advisor

Robert G. Gellin

Abstract

Introduction: Dynamic navigation has the ability to overcome many treatment limitations encountered when using static guides; however, its use for endodontic access is just beginning to be explored. The accuracy of new navigation systems needs to be further evaluated. The aim of this study is to evaluate angular deviations and position deviations of endodontic access preparations compared with the digital file plan, and the ability to provide straight-line access to the canal orifice as shown by the angle of deflection of inserted files. Methods: Thirty-two extracted human teeth were placed into two maxillary and two mandibular jaw models. Preoperative CBCT scans were uploaded into the X-Nav software, and access cavities were virtually planned. After access cavity preparation by two operators, postoperative CBCT scans were superimposed on the virtual plans. Accuracy was measured by calculating the angular deviations and position deviations of endodontic access preparations compared with the virtual plans, and the ability to provide straight-line access to the canal orifice as shown by the angle of deflection of inserted files. Results: All root canals were accessible after access preparation. Straight line access into canals was achieved with a low average file deviation angle of 5.19° ± 3.09°. Relative to the preoperative access plan, the angular accuracy of drilled access using the tested device was 3.55° ± 1.87° for posterior teeth. Positional accuracy was 0.64mm ± 0.29mm measured at the coronal surface and 0.36mm ± 0.20mm measured at the cutting tip of the access bur. Conclusions: This study fills a gap in the current literature, showing that current technology in dynamic navigation enables very accurate and precise endodontic access cavities. Straight line access into canals was achieved with low average file deviation angle, and access cavity results that were accurate with the digitally planned access.

Rights

All rights reserved. Copyright is held by the author.

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