口腔医学研究

口腔医学研究 ›› 2021, Vol. 37 ›› Issue (9): 814-819.DOI: 10.13701/j.cnki.kqyxyj.2021.09.010

• 牙体牙髓病学研究 • 上一篇    下一篇

3D打印技术定位上颌第一磨牙钙化根管口的体外研究

薛媛, 李霞*   

  1. 山西医科大学口腔医学院·口腔医院牙体牙髓病一科,口腔疾病防治与新材料山西省重点实验室 山西 太原 030001
  • 收稿日期:2021-04-07 出版日期:2021-09-28 发布日期:2021-09-16
  • 通讯作者: *李霞,E-mail:lixia6881@163.com
  • 作者简介:薛媛(1993~ ),女,山西太原人,医师,硕士在读,主要从事牙体牙髓及牙周疾病的研究。
  • 基金资助:
    山西省科技攻关项目(编号:20150313010-3)山西医科大学口腔医院科研基金(编号:KY201904)

An in Vitro Study of 3D Printing Technology in Positioning Calcified Root Canal Orifice of Maxillary First Molar

XUE Yuan, LI Xia*   

  1. School of Stomatology, Hospital of Stomatology, Shanxi Medical University, First Department of Endodontics, Key Laboratory of Oral Disease Prevention and New Materials, Shanxi Province, Taiyuan 030001, China
  • Received:2021-04-07 Online:2021-09-28 Published:2021-09-16

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摘要： 目的: 通过体外模拟上颌第一磨牙钙化根管,评价3D打印技术打印的根管导板定位和疏通钙化根管口的准确性,为3D打印导板应用于口内引导磨牙钙化根管的治疗提供先期的实验依据。方法: 选择24颗上颌第一磨牙(排除MB2,根管数量共计72根)。所有根管术前均拍摄CBCT(A组),进行根管倒预备倒充填后模拟钙化根管,再次拍摄CBCT(B组),分析建立模拟钙化根管模型是否成功。确证建模成功后,针对所有模拟钙化根管,使用Eguide种植软件设计并打印3D导板,进行上颌第一磨牙钙化根管口的定位(C组),用ET20超声工作尖按照导板定位的方向去除根管口钙化物至根管口下方2 mm处(D组)。使用mimics 21.0软件测量A、B组根管口和根管口下2 mm处最大近远中径和颊舌径的差值。3-matic13.0软件测量B、C、D组间在根管口及根管口下2 mm处的近远中向、颊舌向、冠根向偏差和角度偏差。结果: 3D打印技术辅助定位上颌第一磨牙模拟的钙化根管口全部成功并疏通。A、B组的差值无统计学意义(P＞0.05)。B、C、D组间三维和角度偏差没有统计学差异(P＞0.05)。结论: (1)本实验中根管倒预备倒充填模拟根管钙化的方法切实可行,可以应用于后续实验。(2)应用3D打印导板定位疏通钙化根管口的方法精确度高,为口内3D打印导板引导疏通磨牙钙化根管提供前期的实验依据。

关键词: 3D打印技术, 3D打印导板, 牙髓钙化, 根管治疗, 上颌第一磨牙

Abstract: Objective: To evaluate the accuracy of positioning and clearing the calcified root canals by a root canal guide by simulating the calcified root canals of the maxillary first molars in vitro. Methods: Twenty four extracted maxillary first molars were selected (excluding MB2, the total number of root canals was 72). For set A, CBCT was taken before all root canals were prepared and obturated to simulate calcified root canals. CBCT was taken again (set B) to analyze whether the establishment of the simulated calcified root canal model was successful. After confirming, for all simulated calcified root canals, Eguide implant software was used to design and print a 3D guide plate to locate the calcified root canal orifices of maxillary first molars (set C). ET20 ultrasound tip was used to locate the orifices of root canals according to the guide plate. The calcified root canals were cleared to 2mm below the root canal orifices (set D). The mimics 21.0 software was used to measure the difference between the maximum mesio-distal and bucco-lingual diameters at 2mm below the root canal orifices in sets A and B. The matic 13.0 software was used to measure the mesio-distal, buccal-lingual, corono-apical, and anglular deviations between the B, C, and D sets at the level of the root canal orifices and 2 mm below the root canal orifices. Results: The 3D printing technology assisted in positioning and clearing the simulated calcified root canal orifice of the maxillary first molar successfully. The difference between sets A and B was not statistically significant (P>0.05). The 3D printing technology assisted in positioning and clearing the simulated calcified root canal orifice of the maxillary first molar successfully. There were no statistical differences in the three-dimensional and angular deviations between sets B, C, and D (P>0.05). Conclusion: (1) The method of simulating root canal calcification in this experiment is feasible and may be applied to subsequent experiments. (2) The method of using 3D printed guides to locate and clear calcified root canals is highly accurate, and provides a preliminary experimental basis for the 3D printed guides in the mouth to guide the clearing of calcified root canals of molars.

Key words: 3D printing technology, 3D printing guide, canal calcification, root canal treatment, the maxillary first molar