Accuracy of Endodontic Access Cavities Performed Using an Augmented Reality Appliance: An In Vitro Study

Introduction: The purpose of this study was to compare and contrast the accuracy of endodontic access cavities created using an augmented reality appliance to those performed using the conventional technique. Materials and Methods: 60 single-rooted anterior teeth were chosen for study and randomly divided between two study groups: Group A—endodontic access cavities created using an augmented reality appliance as a guide (n = 30) (AR); and Group B—endodontic access cavities performed with the manual (freehand) technique (n = 30) (MN). A 3D implant planning software was used to plan the endodontic access cavities for the AR group, with a cone-beam computed tomography (CBCT) and 3D intraoral surface scan taken preoperatively and subsequently transferred to the augmented reality device. A second CBCT scan was taken after performing the endodontic access cavities to compare the planned and performed endodontic access for accuracy. Therapeutic planning software and Student’s t-test were used to analyze the cavities at the apical, coronal, and angular levels. The repeatability and reproducibility of the digital measurement technique were analyzed using Gage R&R statistical analysis. Results: The paired t-test found statistically significant differences between the study groups at the coronal (p = 0.0029) and apical (p = 0.0063) levels; no statistically significant differences were found between the AR and MN groups at the angular (p = 0.6596) level. Conclusions: Augmented reality devices enable the safer and more accurate performance of endodontic access cavities when compared with the conventional freehand technique.

[1]  M. Alam,et al.  Augmented Reality and Virtual Reality in Dentistry: Highlights from the Current Research , 2022, Applied Sciences.

[2]  Á. Zubizarreta-Macho,et al.  A Novel Digital Technique to Analyze the Wear of CM-Wire NiTi Alloy Endodontic Reciprocating Files: An In Vitro Study , 2022, International journal of environmental research and public health.

[3]  Hossein Hassani,et al.  Shaping the Future of Smart Dentistry: From Artificial Intelligence (AI) to Intelligence Augmentation (IA) , 2021, IoT.

[4]  J. Montiel-Company,et al.  Effect of Computer-Aided Navigation Techniques on the Accuracy of Endodontic Access Cavities: A Systematic Review and Meta-Analysis , 2021, Biology.

[5]  Á. Zubizarreta-Macho,et al.  Influence of Drilling Technique on the Radiographic, Thermographic, and Geomorphometric Effects of Dental Implant Drills and Osteotomy Site Preparations , 2020, Journal of clinical medicine.

[6]  S. Sauro,et al.  The Efficacy of Rotary, Reciprocating, and Combined Non-Surgical Endodontic Retreatment Techniques in Removing a Carrier-Based Root Canal Filling Material from Straight Root Canal Systems: A Micro-Computed Tomography Analysis , 2020, Journal of clinical medicine.

[7]  J. Ray,et al.  Targeted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison. , 2020, International endodontic journal.

[8]  Á. Zubizarreta-Macho,et al.  Accuracy of Computer-Aided Dynamic Navigation Compared to Computer-Aided Static Procedure for Endodontic Access Cavities: An In Vitro Study , 2020, Journal of clinical medicine.

[9]  Dario Di Nardo,et al.  Endodontic Microsurgery Using Dynamic Navigation System: A Case Report. , 2019, Journal of endodontics.

[10]  C. Marchetti,et al.  Augmented reality for dental implantology: a pilot clinical report of two cases , 2019, BMC oral health.

[11]  George A Mandelaris,et al.  Accuracy of a Dynamic Dental Implant Navigation System in a Private Practice. , 2019, The International journal of oral & maxillofacial implants.

[12]  Ren-Yeong Huang,et al.  Accuracy of Implant Placement with a Navigation System, a Laboratory Guide, and Freehand Drilling. , 2018, The International journal of oral & maxillofacial implants.

[13]  H. Liao,et al.  Evaluation of the 3D Augmented Reality-Guided Intraoperative Positioning of Dental Implants in Edentulous Mandibular Models. , 2018, The International journal of oral & maxillofacial implants.

[14]  M. Ferrari,et al.  Influence of Access Cavity Preparation and Remaining Tooth Substance on Fracture Strength of Endodontically Treated Teeth , 2018, Journal of endodontics.

[15]  L. Testarelli,et al.  Cone-beam computed tomographic analysis on root and canal morphology of mandibular first permanent molar among multiracial population in Western European population , 2018, European Journal of Dentistry.

[16]  Rui Figueiredo,et al.  Accuracy and the role of experience in dynamic computer guided dental implant surgery: An in-vitro study , 2018, Medicina oral, patologia oral y cirugia bucal.

[17]  Michelle C. Giacomino,et al.  Targeted Endodontic Microsurgery: A Novel Approach to Anatomically Challenging Scenarios Using 3‐dimensional–printed Guides and Trephine Burs—A Report of 3 Cases , 2018, Journal of endodontics.

[18]  Dario Di Nardo,et al.  Cone-beam computed tomography in the assessment of periapical lesions in endodontically treated teeth , 2018, European Journal of Dentistry.

[19]  Álvaro Zubizarreta-Macho,et al.  Endodontic treatment of dens evaginatus by performing a splint guided access cavity , 2017, Journal of esthetic and restorative dentistry : official publication of the American Academy of Esthetic Dentistry ... [et al.].

[20]  R. Bedini,et al.  Fracture Strength of Endodontically Treated Teeth with Different Access Cavity Designs , 2017, Journal of endodontics.

[21]  S. Rengo,et al.  3D cleaning, a perfected technique: thermal profile assessment of heated NaOCl , 2017 .

[22]  M S Zehnder,et al.  Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location. , 2016, International endodontic journal.

[23]  T. Connert,et al.  Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology. , 2016, Dental traumatology : official publication of International Association for Dental Traumatology.

[24]  Alberto Ferreiroa,et al.  Diagnosis and endodontic treatment of type II dens invaginatus by using cone-beam computed tomography and splint guides for cavity access: a case report. , 2015, Journal of the American Dental Association.

[25]  Alejandro Lanis,et al.  The combination of digital surface scanners and cone beam computed tomography technology for guided implant surgery using 3Shape implant studio software: a case history report. , 2015, The International journal of prosthodontics.

[26]  D. Caramella,et al.  Augmented reality as an aid in maxillofacial surgery: validation of a wearable system allowing maxillary repositioning. , 2014, Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery.

[27]  Anil Kishen,et al.  Impacts of conservative endodontic cavity on root canal instrumentation efficacy and resistance to fracture assessed in incisors, premolars, and molars. , 2014, Journal of endodontics.

[28]  M. Trulsson,et al.  Clinical advantages of computer-guided implant placement: a systematic review. , 2012, Clinical oral implants research.

[29]  David Clark,et al.  Modern molar endodontic access and directed dentin conservation. , 2010, Dental clinics of North America.

[30]  S. Patel,et al.  A practical guide to endodontic access cavity preparation in molar teeth , 2007, BDJ.

[31]  T. Buxton,et al.  An in vitro evaluation of the antibacterial efficacy of chlorine dioxide on E. faecalis in bovine incisors. , 2005, Journal of endodontics.

[32]  W. Schindler,et al.  Ideal endodontic access in mandibular incisors. , 1999, Journal of endodontics.

[33]  H. Messer,et al.  Reduction in tooth stiffness as a result of endodontic and restorative procedures. , 1989, Journal of endodontics.

[34]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[35]  Jacob Cohen A Coefficient of Agreement for Nominal Scales , 1960 .

[36]  J. Makdissi,et al.  Computer-aided dynamic navigation: a novel method for guided endodontics. , 2019, Quintessence international.

[37]  Robert W Emery,et al.  Implant Placement Accuracy Using Dynamic Navigation. , 2017, The International journal of oral & maxillofacial implants.

[38]  J F Siqueira,et al.  Aetiology of root canal treatment failure: why well-treated teeth can fail. , 2001, International endodontic journal.

[39]  D. B. Gilboe,et al.  Labial endodontic access opening for mandibular incisors: endodontic and restorative considerations. , 1991, Journal.