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Journal of Peking University (Health Sciences) ›› 2022, Vol. 54 ›› Issue (1): 146-152. doi: 10.19723/j.issn.1671-167X.2022.01.023

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In vitro evaluation of positioning accuracy of trephine bur at different depths by dynamic navigation

LIU Si-min1,ZHAO Yi-jiao2,WANG Xiao-yan1,WANG Zu-hua1,△()   

  1. 1. Department of Conservative Dentistry and Endodontics, Peking University School and Hospital of Stomatology, Beijing 100081, China
    2. Center for Digital Dentistry, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry, Beijing 100081, China
  • Received:2021-10-09 Online:2022-02-18 Published:2022-02-21
  • Contact: Zu-hua WANG E-mail:wangzuhua@pkuss.bjmu.edu.cn

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Abstract:

Objective: To evaluate the accuracy of trephine bur drilling at different depths guided by dynamic navigation system in 3D printing in vitro model. Methods: A model at the depth of 5 mm, 10 mm, and 15 mm from the outer surface of which hemispherical cavities was reserved and the 3D printing technology was used to make the standardized model with Veroclear resin. The cone beam CT (CBCT) was taken and the data were imported into the dynamic navigation software (DCARER, China) to establish navigation path programming. Under the guidance of dynamic navigation, a trephine bur with a diameter of 4.5 mm was used to complete the access operation. At each depth, 10 approaches were completed. The postoperative model CBCT was taken. The approach trajectory under navigation was reconstructed and compared with the designed path. The two-dimensional distance deviation, depth deviation, three-dimensional distance deviation, and angle deviation between the actually prepared path and the designed path were calculated. Results: At the depth of 5 mm, the two-dimensional distance deviation between the end position of the prepared path and the designed path was (0.37±0.06) mm, the depth deviation was (0.06±0.05) mm, the three-dimensional distance deviation was (0.38±0.07) mm, and the angle deviation was 2.46°±0.54°; At the depth of 10 mm, the four deviations between the end position of prepared path and the designed path were (0.44±0.05) mm, (0.16±0.06) mm, (0.47±0.05) mm, and 2.45°±1.21°, respectively; At the depth of 15 mm, the four deviations were (0.52±0.14) mm, (0.16±0.07) mm, (0.55±0.15) mm, and 3.25°±1.22°, respectively. With the increase of entry depth, the three-dimensional and depth accuracy of dynamic navigation system decreased (P<0.01), and the positioning angle deviation had no relation with the entry depth (P>0.01). Conclusion: Dynamic navigation technology can achieve high positioning accuracy in the depth range of 15 mm, but its deviation increases with the increase of entry depth.

Key words: Dynamic navigation, Printing, three-dimensional, Dental models, Fiducial markers

CLC Number: 

  • R783.3

Figure 1

Design of navigation approach A, 3D perspective view of model; B, side view of the model, reserved cavity positions at different depths; C, three dimensional image of approach design in navigation system; D, use a 4.5 mm diameter boneless ring drill; E, design drawing of the axial plane approach in the navigation system; F, design drawing of the sagittal approach in the navigation system; G, periimplant density."

Figure 2

Preparation before dynamic navigation A, calibrate the handpiece; B, fix the model on the table."

Figure 3

Operation under dynamic navigation A and D, model and trephine bur from three-dimensional perspective; B, sagittal plane of model; C, horizontal plane of model; E, distance tolerance; F, angle tolerance; G, in the 5 mm group, the trephine bur was guided to a depth of 0.1 mm under navigation; H, guide the trephine bur into the depth of 3.0 mm, and the color of the depth prompt column changes; I, depth reaches target position."

Figure 4

Evaluation of positioning accuracy and angle deviation A, the postoperative model was reconstructed in MIMICS software; B, fit the drill needle approach in Geomagic software; C, navigation approach deviation analysis diagram. a, 2D distance deviation; b, depth deviation; c, 3D distance deviation; d, angle deviation; e, initial position deviation."

Table 1

Position deviation and angle deviations of navigation end position at different entry depths"

Deviations Overall data Depth F P
5 mm 10 mm 15 mm
2D distance deviation/mm, x ?±s 0.44±0.12 0.37±0.06 0.44±0.05 0.52±0.14 5.751 0.008
Depth deviation/mm, $\bar{x}\pm s$ 0.13±0.78 0.06±0.05 0.16±0.06 0.16±0.07 6.915 0.004
3D distance deviation/mm, $\bar{x}\pm s$ 0.47±0.12 0.38±0.07 0.47±0.05 0.55±0.15 4.509 0.020
Angle deviation/(°), $\bar{x}\pm s$ 2.72±1.12 2.46±0.54 2.45±1.21 3.25±1.22 1.780 0.188
Initial position deviation/mm, $\bar{x}\pm s$ 0.62±1.73 0.57±0.10 0.55±0.11 0.74±0.20 7.662 0.002

Table 2

LSD post test of navigation end position deviations at different entry depths"

Dependent variable Depth of
group 1/mm		 Depth of
group 2/mm		 P
2D distance deviation
5 10 0.177
5 15 0.002
10 15 0.057
3D distance deviation
5 10 0.071
5 15 0.001
10 15 0.077
Depth deviation
5 10 0.003
5 15 0.002
10 15 0.862
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