ArticleClinical, cosmetic and investigational dentistry2025
Custom Sleeve Parameters in Static Guided Endodontic Access: Influence on Deviation Control in Pulp Canal Obliteration.
Article in Clinical, cosmetic and investigational dentistry, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
Purpose: Pulp canal obliteration (PCO) narrows the root canal, complicating access and increasing treatment risks. This study aims to evaluate the accuracy of static guided endodontic access (SGEA) using custom sleeves of different materials and heights compared to conventional freehand access (FHA) in pulp canal obliteration. Methods: An in vitro experimental study was conducted using 48 resin maxillary incisors modeled to simulate pulp canal obliteration via CBCT, intraoral scanner, and 3D printing. The samples were divided into eight groups (n=6): a negative control (freehand access-FHA), a positive control (Titanium Steco 5 mm sleeve), and six static guided endodontic access (SGEA) groups using custom inner sleeves made of Chrome-Cobalt (CoCr) and Zirconia at three heights (3 mm, 5 mm, and 7 mm). Coronal and sagittal deviations between pre- and postoperative CBCT scans were analyzed using one-way ANOVA and Bonferroni post hoc tests (α=0.05). Results: All SGEA groups demonstrated significantly lower deviation values compared to freehand access (p < 0.05). The mean coronal deviation ranged from 1.83° to 6.90°, with the lowest value observed in the Zirconia 7 mm sleeve group (1.83°±1.84°). Sagittal deviation ranged from 2.48° to 30.08°, also lowest in the Zirconia 7 mm group (2.48°±2.43°) and highest in the freehand access group (30.08°±5.93°). Increased sleeve height improved angular precision, and zirconia demonstrated superior dimensional stability compared to chrome-cobalt and titanium. Conclusion: The SGEA technique provided higher accuracy than freehand access in controlling drilling deviation. Among the tested parameters, the custom 3D-printed zirconia sleeve with a 7 mm height yielded the best precision, supporting its potential use in minimizing iatrogenic risk during endodontic access of obliterated canals. This in vitro study on resin models requires further in vivo validation for clinical application.
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