Endodontic disease and periapical disease
Conditions
Interventions
Free hands for calcified root canals group:Localization of calcified root canal by free hand
Dynamic navigation for calcified root canals group:Localization of calcified root canal with dynamic navigation
Free hands for endodontic microsurgery group:Apical positioning and fenestration by free hand
Dynamic navigation for endodontic microsurgery group:Apical localization and fenestration assisted by dynamic navigation
Sponsors
The Affiliated Stomatological Hospital of Nanjing University Medical School
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Inclusion criteria for calcified root canals: (1) Clinically and with auxiliary examinations diagnosed as acute or chronic pulpitis or periapical periodontitis; (2) No previous pulp therapy; (3) X-ray images show diffuse obstruction shadow in the upper two-thirds of the root canal, with no obstruction shadow in the curved lower segment; (4) Voluntarily participate in the study and sign the informed consent form. 2. Inclusion criteria for periapical surgery research: (1) Refractory chronic periapical periodontitis with periapical bone destruction and non-healing fistulae; (2) Coexistence of canal calcification and periapical radiolucency, making conventional root canal treatment impossible or unsuccessful; (3) The apex has not yet fully developed, the apical foramen is open, making pulp revascularization or apexification impossible, or the induction has failed; (4) Pathological resorption of the apex, apical fracture, or apical anatomical variation, with failed non-surgical treatment; (5) Iatrogenic factors: broken instruments in the root canal cannot be removed; significant overfilling of the root canal accompanied by discomfort; stepped canal that cannot be cleared; infected lateral canal perforation; (6) Post and crown cannot be removed, or removing the post carries a high risk of root fracture; (7) True cysts that do not heal after non-surgical treatment; (8) The diameter of the periapical lesion area is less than 6 mm, the labial/buccal cortical bone is intact, and the localization of the tooth apex and lesion area is difficult; (9) Voluntarily participate in the study and sign the informed consent form.
Exclusion criteria
Exclusion criteria: 1. Exclusion criteria for calcified root canals: (1) Teeth with no restorative value; (2) Patients unable to cooperate to complete root canal treatment; (3) Non-initial root canal treatments with filling material inside the canal; (4) X-rays showing diffuse obstructive shadows in the apical curved segment of the canal. 2. Exclusion criteria for apical surgery: (1) Conventional root canal (re)treatment can cure periapical lesions; (2) Teeth that are non-functional or cannot be restored, teeth without sufficient periodontal support, or teeth with combined periodontal-endodontic lesions; (3) Patients unable to cooperate; patients with serious systemic diseases, such as hypertension (>100/180mmHg), diabetes (fasting blood glucose >8.88 mmol/L), hematologic diseases, malignant tumors, severe metabolic diseases, history of radiotherapy or chemotherapy, HIV infection; patients taking bisphosphonates.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Success Rate of Calcified Canal Localization;Apical deviation distance;Measure the deviation angle via the central axis;Amount of hard dental tissue loss;Treatment safety: occurrence of lateral root canal perforation and root fracture; | — |
Secondary
| Measure | Time frame |
|---|---|
| Evaluate the operation time for calcified root canal localization;Distance of deviation at the root canal orifice; | — |
Countries
China
Contacts
Public ContactTing Liu
The Affiliated Stomatological Hospital of Nanjing University Medical School
Outcome results
None listed