(PR053) Simulated Calcified Canal Access Comparison Between Real-time Image Guidance System and Conventional Free-hand Technique

Non-surgical root canal treatment (NSRCT) for pulp chambers and canal obliteration (PCO), associated with trauma, carious lesions, and aging, is clinically challenging to access canals due to calcification. A real-time image guidance (RTIG) system with ultrasonics has been introduced as a new, conservative, and efficient technique to avoid iatrogenic errors. However, few studies have compared the RTIG system with the conventional free-hand technique. This study aimed to measure pre- and post-operative access volume for two techniques. 40 extracted human maxillary molars teeth were used for the study. After removing the crowns, a flowable composite (3M Filtek Supreme A2) was injected into mesial-buccal, distal-buccal, and palatal canals. Each tooth was mounted on ModuPro Endo modules (Accidental) for anatomical position standardization, followed by pre-operative CBCT scanning. Teeth were randomly divided into two groups of 20 teeth each. The RTIG system used X-Guide NXT (X-Nav Technologies (Group A). The free-hand access technique group (Group B) used high/slow-speed handpieces. Both groups used a K0209 Ultrasonic Tip (Brassler) and the dental chair to simulate a reclined patient. Post-operative CBCT scans were taken. Imaris image analysis software (Oxford Instruments) measured pre- and post-operative access volume (mm3). The average (SD) volume (mm3) change was 68.6667 (12.1106) in Group A and 79.6000 (16.5089) in Group B. There was not statistical significance between the two groups (p >0.05) This result indicates that further research needs to be conducted to evaluate whether the RTIG system is indeed a more conservative technique than the conventional free-hand technique.