PubMed · 14240791
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C A LEVINSON. APICOECTOMY.. https://pubmed.ncbi.nlm.nih.gov/14240791/
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BACKGROUND: Selective reduction of bone without injuring inner structures is an essential part of surgical techniques, especially during dental surgery. Virtual drilling is possible using a new simulator. The following illustrates simulation of an apicectomy. MATERIAL AND METHODS: Using the VOXEL-MAN system, a virtual three-dimensional model of a skull was created based on CT data. Both inferior alveolar nerves and apical inflammations of teeth 23, 25, 36, and 35 were virtually simulated. To achieve a realistic drilling effect with the force feedback system, special tools were integrated into VOXEL-MAN to obtain a high resolution of collision recognition. Adding drilling noises further improved the simulation. Spatial 3D perception was possible with the help of shutter glasses. RESULTS: The presented computer model enabled the visual and haptic observation of complex volume-based models and virtual interaction with them. The haptic feeling proved to be convincing because of collision recognition, consideration of drilling parameters, and addition of drilling noises. Via postoperative reconstructions, polydimensional verification of performed drilling routes is possible. CONCLUSION: Using apicectomies as examples, realistic simulation of dental surgical procedures, even in complex anatomical models, is possible. Generally, it is possible to add virtual pathologies in data sets and/or to use anonymous patient data sets to extend the range of simulated surgical procedures.
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OBJECTIVE: The dentinal walls of root-end cavities were examined for the presence of cracks and debris in correlation with the area of the root surfaces that remained after the resection. STUDY DESIGN: One hundred extracted single-rooted teeth were endodontically treated, mounted in acrylic resin blocks, and the apical 2 mm of the root-apex was resected. According to the resected root surface area the teeth were divided into 2 groups having large (>2 mm(2)) or small (<2 mm(2)) surface area. For retrograde cavity preparation 4 devices were used: slow-speed handpiece, diamond coated stainless steel ultrasonic tip, smooth stainless steel ultrasonic tips, and sonic diamond-coated tips. Teeth were examined under a videomicroscope for the presence of fractures, dentin chips, and gutta-percha remnants on cavity walls. Preparation time was also recorded. RESULTS: Preparation with smooth stainless steel ultrasonic tips produced few intradentin cracks. Dentin debris was more frequently seen in rotary preparations whereas gutta-percha remnants were seen mainly at ultrasonically prepared teeth. CONCLUSIONS: Sonic and ultrasonic devices produced cleaner, well-centered, and more conservative root-end cavities than the rotary instrumentation. Cracks do not correlate directly with the surface area of the root-end surfaces but rather with the type of retrotip used to prepare the root-end cavity.