Rehberli Endodonti
Özet
Rehberli endodonti, dijital diş hekimliğindeki yeniliklerin endodontik tedaviye uyarlanmasıyla ortaya çıkan ve özellikle pulpa kanalı obliterasyonu (PCO) ve kompleks kök kanal anatomilerine sahip dişlerde yüksek başarı oranı sunan bir tekniktir. Bu yaklaşım, konik ışınlı bilgisayarlı tomografi (CBCT), intraoral taramalar, CAD/CAM yazılımları ve 3D baskı teknolojileri kullanılarak planlanan giriş yollarının, statik veya dinamik navigasyon sistemleri aracılığıyla klinik uygulamaya aktarılmasına dayanır. Statik navigasyon, kişiye özel şablonlarla sabit doğrultuda yönlendirme sağlarken; dinamik navigasyon, optik sensörler yardımıyla hekimin frez hareketlerini gerçek zamanlı olarak yönlendirir. Literatürde her iki sistemin de minimal invaziv giriş kavitesi hazırlığında, işlem süresinin kısaltılmasında, dentin kaybının azaltılmasında ve komplikasyon risklerinin düşürülmesinde yüksek etkinlik sunduğu bildirilmiştir. Rehberli endodonti, PCO olgularının yanı sıra retreatment, fiber post uzaklaştırma, dens invaginatus, apikal cerrahi ve ototransplantasyon gibi farklı klinik endikasyonlarda kullanılmaktadır. Bununla birlikte, teknik sınırlılıklar, maliyet, vaka seçimi ve operatör deneyimi gibi faktörler tedavi başarısını doğrudan etkilemektedir. Güncel çalışmalar, rehberli endodontinin minimal invaziv yaklaşımı ve öngörülebilirliğiyle klinik pratikte güçlü bir alternatif sunduğunu ortaya koymaktadır.
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