RESUMO
PURPOSE: The purpose of this cadaveric study was to compare the volume and weight of bone graft harvested using the curettage vs. the trephination technique from the anterior iliac crest. METHODS: Embalmed cadavers were studied in this experimental research. The right hemipelvis of each cadaver was used for the trephine bone harvesting technique, whereas the left hemipelvis was used for the conventional curettage technique. The weight and the volume of the harvested bone were measured and statistically compared between the 2 sides. The Wilcoxon Signed-Rank test was employed to compare the graft volume and weight obtained from the right and left sides of the hemipelvis. RESULTS: Ten embalmed adult cadavers were used in this study. All subjects were Caucasian males with a mean age of 59.8 years (range 44 - 73 years) at the time of death. A total of 81 cylindrical bone grafts were harvested from the right iliac crest. In 9 out of 81 (11.1 %), the cortex of the ilium was penetrated by the chisel. The mean weight of the bone graft harvested with the trephine technique (26.97 ± 2.32) g was heavier than the curettage technique (23.74 ± 2.09) g (p = 0.007). Similarly, the volume of the bone graft was higher in the trephine technique (8.40 ± 0.84) cm3 compared to the curettage technique (6.60 ± 1.26) cm3 (p = 0.011). The trephination technique lasted a mean of (12.76 ± 1.87) min (range 10.30-16.10 min), while the curettage technique lasted a mean of (14.53 ± 0.89) min (range 13.50-16.00 min) (p = 0.028). CONCLUSION: Harvesting anterior iliac crest bone graft with the trephine technique provides a higher bone volume and weight than the conventional curettage technique. The trephine technique might be advocated over the curettage technique, especially when a large amount of autologous bone graft is required. However, a meticulous harvesting technique should be followed to prevent complications, particularly the three-dimensional anatomy should be kept in mind, and the depth of trephination should be well-controlled. CLINICAL TRIAL REGISTRATION: Institutional Review Board registration: 2022/499.
RESUMO
INTRODUCTION: The aim of this in vitro study was to evaluate the effects on root dentin of 2 trephining techniques using an ultrasonic tip or a trepan bur in the mesial canals of mandibular molars during attempts to remove fractured file fragments using micro-computed tomographic imaging. METHODS: Twenty-one teeth with a similar anatomic configuration in mesial (buccal and lingual) canals were selected. A 4-mm apical segment of K3 file size 25/.06 was fractured in each mesiobuccal and mesiolingual canal 5 mm apically from the canal orifice. A staging platform was prepared at the coronal aspect of the broken instrument followed by either ultrasonics or a new trepan bur technique to expose a 1- to 1.5-mm length of the fragment. If the broken instrument could not be removed by exposing it either by ultrasound or the trepan bur, a microtube device was used to attach to and withdraw the fragment. Micro-CT scanning was performed before and after removing the broken instrument. Canal volume, diameter, and furcal root dentin thickness were measured by using image analysis software. The time required for the removal of the instrument fragments was recorded. The result was statistically analyzed using the paired t test. RESULTS: The trepan bur technique had significantly less impact on canal volume, diameter, and furcal root dentin thickness change than the ultrasonic technique (P < .001). The time consumed for successful removal of the fragments was significantly less in the trepan bur group (8.9 ± 3.5 minutes) than in the ultrasonic group (25 ± 11.9 minutes) (P < .001). CONCLUSIONS: A new small-sized trepan bur technique was superior to the use of ultrasound with regard to the amount of dentin removed and the speed in the removal of fractured instruments from root canals.