Classificação de risco de perfuração radicular em planejamentos digitais para endodontia guiada em dentes anteriores inferiores

Abstract

Objective: To apply a Risk Classification for Root Perforations in mandibular anterior teeth groups using digital planning for Guided Endodontics. Material and Methods: Cone-beam computed tomography (CBCT) scans from 24 patients obtained from the database of the School of Dentistry at the Federal University of Goiás were included. Digital planning for Guided Endodontics was performed using Blue Sky Plan® software, with the access bur positioned at the cervical, middle, and apical thirds of the mandibular anterior teeth. The minimum dentin thickness between the tip of the virtual bur and the external root surface was measured, providing the minimum estimated dentin thickness for each specimen. Based on deviation values reported in the literature, a Root Perforation Risk Classification for Guided Endodontics was proposed, in which estimated dentin thickness values lower than 0.5 mm were classified as High Risk, values between 0.5 and 1.0 mm as Moderate Risk, and values greater than 1.0 mm as Low Risk. Data were statistically analyzed at a significance level of 5%. Results: A statistically significant difference in perforation risk was observed among the root thirds of the mandibular anterior teeth. Central and lateral incisors exhibited estimated dentin thickness values of less than 1 mm in most of the evaluated root thirds, whereas canines showed greater dentin thicknesses, particularly in the cervical region. The central incisors presented the lowest dentin thickness values in the cervical third. Additionally, the lateral incisors exhibited lower dentin thickness values in the cervical and apical thirds when compared with canines (p < 0.001). Conclusion: Mandibular incisors and canines showed a high risk of root perforation in the apical third. In mandibular incisors, the cervical and middle thirds presented a moderate risk of root perforation, whereas in mandibular canines these same thirds exhibited a low risk of root perforation.