口腔疾病防治 ›› 2021, Vol. 29 ›› Issue (7): 479-484.DOI: 10.12016/j.issn.2096-1456.2021.07.008

• 防治实践 • 上一篇    下一篇

椅旁四面体定位技术制作导板拆除纤维桩1例及文献复习

张威龙(),吴婉淇,廖珊华,邹俊斌,詹栩铮,林捷()   

  1. 福建医科大学附属口腔医院特诊科,福建 福州(350002)
  • 收稿日期:2020-12-26 修回日期:2021-03-07 出版日期:2021-07-20 发布日期:2021-04-19
  • 通讯作者: 林捷
  • 作者简介:张威龙,本科,Email: 395711575@qq.com
  • 基金资助:
    福建省卫生健康中青年骨干人才培养项目(2020GGA060);2020年福建省大学生创新创业训练计划项目(C20182)

Fabrication of guide and removal of fiber post by tetrahedron positioning technology at the chair side: a case report and literature review

ZHANG Weilong(),WU Wanqi,LIAO Shanhua,ZOU Junbin,ZHAN Xuzheng,LIN Jie()   

  1. Department of VIP Dental Service, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
  • Received:2020-12-26 Revised:2021-03-07 Online:2021-07-20 Published:2021-04-19
  • Contact: Jie LIN
  • Supported by:
    Fujian Provincial Health Commission Middle and Young Aged Talents Training Project(2020GGA060);Fujian Province Undergraduate Training Program for Innovation and Entrepreneurship(C20182)

摘要:

目的 探讨椅旁四面体定位技术制作导板拆除纤维桩的技术和效果。方法 对1例左上颌侧切牙慢性根尖周炎急性发作且需拆除纤维桩的患者,使用椅旁四面体定位技术制作导板拆除纤维桩。将锥形束CT(cone beam CT,CBCT)数据导入软件进行纤维桩拆除导板设计,利用四面体定位技术,将CBCT上的导板设计转移到实体模型上,制作导板引导拆除纤维桩,后行左上颌侧切牙根管治疗。通过文献回顾,评价四面体定位技术导板拆除纤维桩的效果。结果 四面体定位技术制作导板精准定位了纤维桩的位置和方向,具有低成本、快速的特点;对患者拆除纤维桩后使用根管预备器械可疏通根管,根管预备后热牙胶充填完成根管治疗,3个月后复查根尖片见根尖周透射影缩小。文献复习结果表明,导板拆除纤维桩治疗提供了一个可预测的结果和较低的医源性损害风险,可进行微创治疗,并减少椅旁时间。结论 在CBCT数据基础上使用四面体定位技术制作纤维桩拆除导板有助于降低纤维桩拆除风险,有快速、低成本、椅旁省时的特点,但其与三维打印导板的精确度比较有待进一步研究。

关键词: 纤维桩, 四面体定位, 导板, 锥束计算机断层成像, 椅旁, 三维打印, 精确度, 定位技术, 根管再治疗, 热牙胶充填技术, 微创治疗

Abstract:

Objective To explore the technology and efficacy of fabrication of a guide and removal of a fiber post by tetrahedron positioning technology at the chair side.Methods For one patient with acute chronic periapical periodontitis of the left maxillary lateral incisor who needed to have the fiber post removed, the chair side tetrahedral positioning technique was used to make a guide plate to remove the fiber post. Cone beam CT (CBCT) data were imported into the software to design the guide plate for fiber post removal. The guide plate design on CBCT was transferred to a solid model by using tetrahedral positioning technology. The guide plate was made to guide the removal of the fiber post, and then left maxillary lateral incisor root canal was performed. We evaluated the effect of fiber post removal with tetrahedral positioning technology by reviewing the literature.Results The guide plate made by tetrahedral positioning technology can accurately locate the position and direction of fiber posts at a low cost and with high speed. After the fiber post was removed, the root canal could be dredged by using root canal preparation instruments. After root canal preparation, the root canal was filled with warm gutta-percha to complete the root canal treatment. After 3 months, the apical radiograph showed that the transmission shadow of the apical area was reduced. The results of the literature review showed that the fiber post removal with guide plates provides a predictable result and a lower risk of iatrogenic damage. Minimally invasive treatment can be carried out, and chair time can be reduced.Conclusion On the basis of CBCT data, using tetrahedral positioning technology to make fiber post removal guides can help reduce the risk of fiber post removal and has the characteristics of speed, low cost and short chair side processing. However, the accuracy comparison between tetrahedral positioning technology and 3D printing guides needs further study.

Key words: fiber post, tetrahedron positioning technology, surgical guides, cone beam CT, chair side, three-dimensional printing, accuracy, positioning technology, root canal retreatment, warm gutta-percha filling technique, minimally invasive treatment

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