Date of Award

2018

Document Type

Dissertation

Degree Name

Master of Science (MS)

Department

Oral Rehabilitation

College

College of Dental Medicine

First Advisor

Harmeet D. Walia

Second Advisor

Robert P. Bethea

Third Advisor

Theodore D. Ravenel, V

Abstract

Introduction: Recent studies have shown that conservative endodontic cavities (CECs) have a higher mean load at fracture in molars and premolars compared to traditional access cavities, however, performing these CECs can be challenging for the practitioner. Microguided endodontic access is a reliable means of preserving dentin while gaining access to the pulp chamber. The aim of this study was to 1. Develop a protocol for designing angulation and depth controlled physical guides to perform endodontic access, and 2. To compare its ability to provide straight line access against a decoronated tooth, measuring angle of deflection of inserted files. Materials and Methods: With use of both Kodak Carestream 9000® CBCT scans and Planmeca PlanScan® intraoral scans of acrylic blocks containing extracted teeth, depth and angulation controlled guides were designed with the Planmeca Romexis implant planning software and printed with a Formlabs 2 3D printer. A total of 23 teeth (totaling 76 canals) were accessed using a #4 surgical length round bur with the guides in place. Results: Subjective analysis confirmed passive straight line access with a #6 C file through the CECs for all canals and CBCT images were captured. The imaging was repeated with files in the canal after the teeth were decoronated. Difference in angle of deflection of the files were measured between the 2 models, confirming the clinical finding of passive straight line access. The average file angle deviation was 1.98 ± 1.06° for all canals. No significant differences were seen between tooth types in each arch, nor between arches. File deviation ranged from 0.23° to 5.28°. Conclusion: A protocol was successfully developed to accurately and reproducibly create 3D printed guides for conservative fully-guided endodontic cavity preparation.

Rights

All rights reserved. Copyright is held by the author.

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