Abstract
To compare and contrast the accuracy of piezoelectric ultrasonic insert (PUI) and trephine bur (TB) osteotomy site preparation techniques for apical location. (1) Material and methods: A total of 138 osteotomy site preparations were randomly distributed into one of two study groups. Group A: TB technique (n = 69) and B: PUI technique (n = 69). A preoperative cone-beam computed tomography scan and an intraoral scan were performed and uploaded to implant-planning software to plan the virtual osteotomy site preparations for apical location. Subsequently, the osteotomy site preparations were performed in the experimental models with both osteotomy site preparation techniques and a postoperative CBCT scan was performed and uploaded into the implant-planning software and matched with the virtually planned osteotomy site preparations to measure the deviation angle and horizontal deviation as captured at the coronal entry point and apical end-point between osteotomy site preparations using Student’s t-test statistical analysis. (2) Results: The paired t-test found statistically significant differences at the coronal entry-point deviations (p = 0.0104) and apical end-point deviations (p = 0.0104) between the TB and PUI study groups; however, no statistically significant differences were found in the angular deviations (p = 0.309) between the trephine bur and piezoelectric ultrasonic insert study groups. (3) Conclusions: The results showed that the TB is more accurate than the PUI for apical location.
Highlights
Periapical tissue damage as a result of the pulp necrosis process is considered the most common pathology found in the alveolar bone
(2) Results: The paired t-test found statistically significant differences at the coronal entry-point deviations (p = 0.0104) and apical end-point deviations (p = 0.0104) between the TB and PUI study groups; no statistically significant differences were found in the angular deviations (p = 0.309) between the trephine bur and piezoelectric ultrasonic insert study groups
(3) Conclusions: The results showed that the TB is more accurate than the PUI for apical location
Summary
Periapical tissue damage as a result of the pulp necrosis process is considered the most common pathology found in the alveolar bone. The exposure of dental pulp to bacteria and their products (antigens) can lead to nonspecific inflammatory and specific immune responses in the surrounding root tissues, which can lead to periapical tissues damage [1,2,3,4]. Should root canal treatment fail, non-surgical endodontic retreatment is recommended; said retreatment may decrease success rates by up to 80% [6]. Endodontic microsurgery procedures are recommended when non-surgical endodontic retreatment proves unsuccessful, or in cases in which it would prove impossible or have an unfavorable prognosis [7], such as when orthograde access to the apical area of the root canal system would be ineffective or technically impossible
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