Tooth substance loss after incisal endodontic access and novel single-tooth template-guided endodontic access in three-dimensional printed resin incisors with simulated pulp canal calcification: A comparative in vitro study

Vasudevan A, Sundar S, Surendran S, Natanasabapathy V. Tooth substance loss after incisal endodontic access and novel single-tooth template-guided endodontic access in three-dimensional printed resin incisors with simulated pulp canal calcification: A comparative in vitro study. J Conserv Dent [serial online] 2023 [cited 2023 May 17];26:258-64. Available from: https://www.jcd.org.in/text.asp?2023/26/3/258/376906

 

Abstract

Context (Background): Guided endodontics has various applications, one of which is for calcified canal negotiation. Recently, a new single-tooth template has been fabricated to overcome the drawbacks of bulky guides, which are difficult to use with rubber dam isolation.
Aim: This study aimed to assess the efficacy of the novel single-tooth template for negotiation of pulp canal calcification (PCC) in three-dimensional (3D)-printed resin incisors by comparing substance loss and time taken between incisal endodontic access (IEA) and single-tooth template-guided endodontic access (SGEA).
Methods: Forty-two resin incisor teeth having patent canal in the apical third were used (N = 21/group). They were subcategorized based on operator's experience into senior endodontist (SE), postgraduate (PG), and undergraduate (UG) (n = 7/operator). Canals were negotiated conventionally for IEA and using the single-tooth template for SGEA. Substance loss was calculated from the volume difference between pre- and postoperative cone-beam computed tomography scans. The time taken was also recorded.
Statistical Analysis Used: Statistical analysis was performed using unpaired t-test and one-way analysis of variance test.
Results: Canals were successfully negotiated in 100% and 95% of teeth in the SGEA and IEA groups, respectively. Overall substance loss and time taken were significantly lesser for SGEA for all operators (P < 0.001). In the IEA group, post hoc test showed statistical significance between SE and UG for substance loss (P < 0.05) and SE–UG and PG–UG for time taken (P < 0.05). No significant difference among operators was noted for both parameters in SGEA.
Conclusions: SGEA resulted in significantly lesser substance loss and time taken for canal negotiation in 3D-printed resin incisors with simulated PCC. This was independent of the experience levels of the operator.