An applied research on computer-aided canal negotiation of the distal lingual root of mandibular first molar for endodontic treatment
AIM:This study aims to compare the effectiveness of traditional versus computer-aided methods in the negotiation of the distal lingual canal(DLC)in mandibular first molars.METHODS:A total of 25 extracted mandibular first molars were selected and their three-dimensional(3D)models were reconstructed.Six 3D-printed replicas of each tooth were produced,resulting in a total of 150 models.These models were then divided into two groups(n=75 each):A traditional group and a computer-aided group.Three endodontic residents,with equal experience,performed canal negotiation on the same 25 teeth in both groups.The success rate of canal negotiation,the time required for completion,and the degree of canal deviation post-negotiation were recorded and analyzed.RESULTS:In the traditional group,the average success rate of canal negotiation was 56.00％,whereas in the computer-aided group,it was 74.67％,representing a significant improvement of 33.34％compared to the traditional method(P＜0.05).The average procedural time for the traditional and computer-aided groups was(351.32±21.13)s,(360.42±36.99)s,respectively.Although the computer-aided group required slightly more time,this difference was not statistically significant(P＞0.05).Notably,the computer-aided group demonstrated significantly less canal deviation at 1mm and 4mm from the apical foramen compared to the traditional group(P＜0.05).Additionally,the canal centering ratio was significantly higher in the computer-aided group,indicating less canal transportation during negotiation(P＜0.05).CONCLUSION:This study demonstrates that while the use of computer-aided analysis of preoperative CBCT images does not significantly impact the duration of canal negotiation in the distal lingual canal of mandibular first molars,it significantly enhances the efficiency and quality of the procedure.By enabling more precise selection of instruments and negotiation techniques,computer-aided analysis minimizes the risk of complications such as ledges and zipping,while preserving the original canal morphology.As a result,a notable improvement in both the success rate and the quality of canal negotiation is achieved.
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