Evaluation of a Novel Drilling Approach for Dynamic Navigation-Aided Endodontic Microsurgery: A Surgical Simulation Comparison Study

ABSTRACT

Introduction

This study investigated the feasibility of a novel drilling approach that integrates a pilot trephine into dynamic navigation (DN) for guided osteotomy and root-end resection (RER) with unimanual operation in endodontic microsurgery (EMS).

Methods

Two operators with varying levels of DN experience performed guided osteotomy and RER using two unimanual drilling methods with DN-aided operation on 3D-printed jaw models. Method 1 (M1) involved drilling with a conventional trephine. Method 2 (M2) involved drilling with a pilot trephine, followed by drilling with a conventional trephine. Accuracy, time, and safety of M1 and M2 were compared. Accuracy measurements included platform deviation (PD), end deviation (ED), angular deviation (AD), resection length deviation (RLD), and resection bevel angle (RBA). Additional parameters included operation time of osteotomy and RER (OT) and bur slippage number (SN). Statistical analyses were conducted using a two-sample t-test or Mann-Whitney U test, with the significance level set at 0.05.

Results

The PD, AD, RBA, and SN in the M2 group were significantly less than in the M1 group (P < .05). For M1, the novel operator (NO) exhibited significantly higher values of PD, ED, OT, and SN than the experienced operator (EO) (P < .05). For M2, the NO exhibited significantly higher value of ED only (P < .05), and drilling depth > 7 mm was significantly associated with a longer OT (P < .05).

Conclusion

In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided EMS.