Method for resin sealing retreatment in medullary cavity after root canal therapy

Abstract

The invention discloses a method for post-root canal therapy resin closure retreatment in a medullary cavity, and relates to the technical field of root canal therapy, and the method comprises the following steps: S1, pre-operation sampling; s2, removing the restoration and other materials: removing the restoration on the surface of the dental crown and the resin sealing material in the medullary cavity by using a material removal technology and a tool, wherein the material removal technology and the tool comprise a grinding device with a sensor or a laser technology; s3, re-cleaning and disinfecting the root canal: after cleaning the root canal, using a root canal disinfection drug added with nano-silver particles, and mixing the nano-silver particles with traditional disinfection drugs such as calcium hydroxide paste; s4, filling and re-treating: blending the color of the resin by using a computer color matching technology before filling the medullary cavity; the system further comprises an intelligent design monitoring platform. According to the invention, a grinding device with a sensor or a laser technology is adopted, so that the damage to tooth tissues, especially key parts, is remarkably reduced, and the treatment safety and accuracy are improved.

Description

Technical Field

[0001] The invention relates to the technical field of root canal treatment, in particular to a method for resin sealing and re-treatment of a pulp cavity after root canal treatment. Background Art

[0002] Root canal therapy is a common method for treating pulp disease and apical periodontitis. It mainly removes the inflammatory pulp and necrotic substances in the root canal, and then disinfects and fills the root canal to prevent the occurrence of apical periodontitis or promote the healing of existing apical periodontitis. After root canal therapy, the pulp cavity is usually sealed, usually with materials such as gutta-percha tips and root canal sealers to fill the root canal system, and then the pulp cavity may be sealed with materials such as resin, which can prevent bacteria from entering the root canal again and protect the internal structure of the tooth. When problems occur in teeth after root canal treatment, such as reinfection after root canal treatment (which may be due to incomplete root canal filling, re-invasion of bacteria, etc.), or recurrence of apical periodontitis, retreatment is required.

[0003] There are many problems in the process of traditional root canal treatment followed by resin sealing of the pulp cavity. First, when removing the original restoration and sealing materials, the lack of accurate monitoring methods often leads to excessive damage to the tooth tissue. Doctors can only rely on experience, which may cause misjudgment when approaching key parts such as the pulp cavity, and wear through the tooth tissue, affecting the structural integrity of the tooth and the subsequent treatment effect; moreover, the lack of accurate methods in selecting the color of the resin may cause the color of the restored tooth to be inconsistent with the surrounding teeth, affecting the appearance.

[0004] In view of this, this application is hereby filed. Summary of the invention

[0005] The object of the present invention is to provide a method for resin sealing and retreatment of the pulp cavity after root canal treatment, so as to solve the problem of damage to tooth tissue mentioned in the above background technology.

[0006] In order to solve the above technical problems, the present invention provides a method for re-treatment of intramedullary cavity resin sealing after root canal treatment, comprising the following steps: S1: preoperative sampling; S2: removal of restorations and other materials: use material removal technology and tools to remove crown surface restorations and intramedullary resin sealing materials, wherein the material removal technology and tools include a grinding device with a sensor or laser technology; the sensor is a depth sensor, and the emitted signal will produce reflection or change when it contacts the interface of different materials; in laser technology, the laser generator generates a high-energy laser beam, so that the resin material molecules absorb energy and undergo chemical bond breaking, sublimation or vaporization physical and chemical changes, thereby achieving material removal; S3: root canal re-cleaning and disinfection: use rubber dam isolation technology in the process of root canal re-cleaning and disinfection, and use nano-silver added after cleaning the root canal. Root canal disinfectant made of nanosilver particles, nanosilver particles are mixed with traditional disinfectants such as calcium hydroxide paste; S4: Filling and re-treatment: In the steps of refilling the pulp cavity and root canal, biocompatible resin materials are given priority. Before filling the pulp cavity, the resin color is adjusted using computer color matching technology. Self-curing resin and light-curing resin are filled according to the prescribed operations. If re-root canal filling is required, the quality of root canal preparation must be ensured and appropriate root canal filling materials must be selected; also includes: Intelligent design monitoring platform: Before treatment, oral CBCT (cone beam CT) and computer-aided design / computer-aided manufacturing (CAD / CAM) technology are used to evaluate the affected teeth and plan the operation process; after surgery, the patient is given medical advice and nursing guidance and regular follow-up and reexamination are arranged. At the same time, intraoperative emergency treatment and pain management measures are available during the treatment process.

[0007] Furthermore, in S1, the patient's medical history is collected and analyzed before surgery, oral examination and imaging review are performed, and patient psychological counseling and informed consent are obtained; including in the medical history collection and analysis steps, detailed inquiries are made about the patient's root canal treatment history, general health status and allergy history, and the information is analyzed to assess the risk of retreatment and special preparation needs. Oral examination and imaging review include a comprehensive examination of the affected teeth and adjacent teeth and a variety of imaging examinations, and indications, contraindications and treatment plans are determined based on the results. Patient psychological counseling and informed consent is to explain the treatment process and situation to the patient and ensure that he understands and signs the consent form.

[0008] Furthermore, in S2, the grinding device with a sensor sends out an alarm when it approaches the safe thickness of the tooth during the grinding process. The doctor adjusts the operating parameters accordingly to reduce damage to the tooth tissue, especially the neck of the tooth and the area near the pulp cavity. The new laser technology sets parameters according to the characteristics of the resin material to reduce thermal effects and mechanical damage to the surrounding tooth tissue in order to handle complex restorations and resin sealing situations.

[0009] Furthermore, in S3, the rubber dam isolation technology completely isolates the affected tooth from the saliva and bacteria in the oral cavity, creates a relatively sterile environment for root canal cleaning and disinfection operations, and reduces the possibility of root canal reinfection. The nanosilver particles, with their small particle size, penetrate deep into the tiny structure of the root canal system, exert a sustained antibacterial effect, effectively kill bacteria, fungi and other microorganisms in the root canal, prolong the antibacterial time, and improve the success rate of retreatment.

[0010] Furthermore, in S4, the color of the resin is prepared using computer color matching technology before filling the pulp cavity. The color parameters of the patient's surrounding tooth tissue are accurately analyzed to match the prepared resin color with the surrounding tooth tissue, thereby improving the aesthetics of the restored teeth. Self-curing resin and light-curing resin are filled according to corresponding operations, and the quality of root canal preparation and the selection of appropriate materials are ensured when re-root canal filling.

[0011] Furthermore, in S5, oral CBCT, i.e. cone beam CT, and computer-aided design / computer-aided manufacturing, i.e. CAD / CAM, technologies are used to evaluate the affected tooth and plan the operation process before treatment. Based on the CBCT display information, CAD / CAM technology is used to reduce unnecessary operation steps and improve the efficiency and quality of retreatment.

[0012] Furthermore, in the intelligent design monitoring platform, postoperative medical instructions and nursing guidance include informing patients to avoid chewing hard food on the affected side, maintaining oral hygiene, avoiding bad habits, and explaining methods to alleviate postoperative reactions. Regular follow-up and review include performing oral and imaging examinations at specific time intervals and dealing with problems found.

[0013] Furthermore, in the intelligent design monitoring platform, intraoperative emergency treatment includes treatment methods for pulp cavity perforation and root canal instrument breakage, and pain management includes selection of appropriate anesthesia methods and drugs, intraoperative and postoperative pain control and treatment measures.

[0014] Compared with the prior art, the present invention has the following beneficial effects:

[0015] 1. The grinding device with sensors can monitor the grinding depth in real time when removing restorations and resin sealing materials. When approaching the safe thickness of the tooth, an alarm is issued, allowing the doctor to adjust the operating parameters in time, significantly reducing damage to the tooth tissue, especially key parts such as the neck of the tooth and the area near the pulp cavity. Laser technology sets parameters based on the characteristics of the resin material. It can effectively decompose or vaporize the restoration and resin material while minimizing the thermal impact and mechanical damage to the surrounding tooth tissue. It can safely handle complex restorations and resin sealing situations, and improve the safety and accuracy of treatment.

[0016] 2. Rubber dam isolation technology can completely isolate the affected tooth from the saliva and bacteria in the oral cavity during the root canal re-cleaning and disinfection process, creating a nearly sterile environment for root canal cleaning and disinfection operations, greatly reducing the possibility of root canal reinfection. Root canal disinfection drugs with added nano-silver particles can penetrate deep into the tiny structure of the root canal system due to their extremely small particle size, and continue to exert a powerful antibacterial effect. They can effectively kill various bacteria, fungi and other microorganisms in the root canal, including drug-resistant bacteria, and have a long antibacterial effect, which significantly improves the success rate of retreatment and effectively solves the infection control problem of traditional disinfection methods; enhances infection control and reduces surgical risks;

[0017] 3. In the step of refilling the pulp cavity, use computer color matching technology to mix the resin color. Through accurate analysis of the color parameters of the patient's surrounding tooth tissue, the mixed resin color can be perfectly matched with the surrounding natural teeth. Whether it is the front teeth or the back teeth, it can significantly improve the aesthetics of the restored teeth and meet the patient's needs for beauty. Select a new resin material with better biocompatibility and low shrinkage rate. This material will not cause inflammation, allergies and other adverse reactions in the surrounding tissues after implantation in the human body, which is beneficial to the long-term health of the dental pulp and periapical tissues. At the same time, the low shrinkage rate characteristic can effectively reduce the occurrence of microleakage and prevent bacteria and oral fluids from entering the pulp cavity or root canal through microleakage, thereby reducing the risk of recurrence of pulpitis or periapical lesions, and improving the long-term effect of retreatment; improve the aesthetics of the restoration and material performance;

[0018] 4. Use oral CBCT and CAD / CAM technology to evaluate the affected teeth and plan the operation process before treatment. The detailed information provided by CBCT, such as the three-dimensional morphology of the root canal, the original filling material, and the thickness distribution of the tooth tissue, provides a key basis for doctors to formulate treatment plans, allowing doctors to operate more accurately during the root canal re-cleaning process, reduce unnecessary exploration and cleaning steps, and avoid damage to normal tooth tissue and root canal structure. CAD / CAM technology pre-plans the method and thickness of resin filling, as well as the operation trajectory of root canal preparation based on CBCT information, reducing repeated attempts during the operation, significantly shortening the operation time, improving the efficiency and quality of retreatment, and improving the overall treatment effect; improving treatment efficiency and quality;

[0019] 5. Through the design of intelligent design monitoring platform, before the operation: conduct a comprehensive assessment of the affected teeth. It can clearly understand the specific conditions of the affected teeth, such as accurately grasping the internal structure of the teeth based on the CBCT display information, and provide a detailed basis for the subsequent formulation of a reasonable treatment plan; plan the operation process based on the evaluation results, which can reduce unnecessary operation steps, improve the quality of retreatment, and ensure that the treatment effect is more in line with expectations; after the operation: guide patient care and promptly discover and deal with problems; during the operation: respond to emergencies and effectively control pain. BRIEF DESCRIPTION OF THE DRAWINGS

[0020] Figure 1 The invention is a principle block diagram of a method for retreatment of intramedullary cavity resin sealing after root canal treatment. DETAILED DESCRIPTION

[0021] The following will be combined with the drawings in the embodiments of the present invention to clearly and completely describe the technical solutions in the embodiments of the present invention. Obviously, the described embodiments are only part of the embodiments of the present invention, not all of the embodiments. Based on the embodiments of the present invention, all other embodiments obtained by ordinary technicians in this field without creative work are within the scope of protection of the present invention.

[0022] See also Figure 1 The present invention provides a technical solution: a method for resin sealing retreatment of the pulp cavity after root canal treatment, comprising the following steps:

[0023] 1. Preoperative patient assessment and preparation:

[0024] Medical history collection and analysis:

[0025] Arrange special medical staff to communicate with patients in detail. Ask patients when they first had root canal treatment, for example, the patient recalled that they had root canal treatment for pulpitis two years ago. Understand the reason for the treatment, whether it was caused by caries or other factors such as trauma. Ask if there were any special circumstances during the treatment, such as the patient mentioned that there was slight pain after root canal treatment for about a week, but it was relieved without special treatment. At the same time, ask about the postoperative recovery, including whether the chewing function is normal, whether there is swelling or other discomfort, etc.

[0026] Fully understand the patient's overall health status, including whether they have systemic diseases such as hypertension, heart disease, and diabetes. For example, if the patient indicates that they have diabetes, detailed questions about blood sugar control are required. Ask the patient about their allergy history, such as whether they are allergic to certain drugs (such as penicillin, cephalosporins) or oral materials. Assess the risk of retreatment based on this information. For diabetic patients, since their wounds may heal more slowly, they need to be treated with good blood sugar control and strengthen anti-infection measures after surgery. For patients with a history of allergies, avoid using materials that may cause allergies.

[0027] Oral examination and imaging review:

[0028] The doctor conducts a comprehensive examination of the patient's oral cavity. Visually examine the affected tooth and adjacent teeth to see if the color and shape of the tooth surface are normal, whether there are new signs of caries, or whether the edges of the restorations are tight. For example, it is found that the crown of the affected tooth is slightly darker in color, and the adjacent teeth have slight pigmentation. Use a probe to check the caries and defects of the teeth, probe the edges of the restorations of the affected teeth to see if there are gaps, check the gums for redness, swelling, and bleeding, and probe the depth of the periodontal pockets. Percuss the affected tooth and adjacent teeth to determine the reaction of the pulp and periapical tissues, such as no obvious pain or discomfort when percussing the affected tooth. Check the looseness of the teeth, and the affected teeth are not obviously loose.

[0029] In addition to using oral CBCT, oral panoramic films and periapical films are also used for imaging examinations. Oral panoramic films can be used to observe the arrangement of all teeth, the general shape and density of the alveolar bone. Periapical films can more clearly show the length, shape, and approximate number and direction of the root of the affected tooth. CBCT can provide three-dimensional information about the root canal system, including the number, curvature, and length of the root canals, and observe the situation of the original fillings in the root canals, such as whether there is overfilling or underfilling, and the thickness distribution of the tooth tissue. For example, the CBCT image shows that the affected tooth has three root canals, one of which has a slight underfilling of the filling in the apical third of the root canal, and the thickness of the tooth tissue at the neck of the tooth is thinner in some parts. The indications and contraindications for retreatment are determined based on these examination results. For this tooth, retreatment is indicated due to the underfilling of the root canal filling; if the patient's general condition is poor and cannot tolerate the treatment, it is a contraindication. A personalized treatment plan is also formulated, including the expected number of treatments and possible materials to be used.

[0030] Patient psychological counseling and informed consent:

[0031] The doctor explained the process of post-root canal treatment to the patient in detail. The patient was informed that the original restoration and the sealing material in the pulp cavity needed to be removed first. This process might cause some slight vibration, but it would not be painful. The root canal would then be cleaned and disinfected again, and then the pulp cavity and root canal would be refilled according to the situation.

[0032] Explain to the patient what may happen, such as the possibility of brief pain during treatment, especially when dealing with root canals, if the pulp is still partially alive. Inform the patient that there may be slight swelling after surgery, which is a normal postoperative reaction and generally subsides within a few days. Introduce the treatment cycle to the patient, which will probably require multiple visits, each lasting about 1-2 hours. Inform the patient of the approximate cost range, including material costs, treatment costs, etc. Relieve the patient's nervousness through patient explanations, and ensure that the patient fully understands and signs the informed consent form.

[0033] 2. Removal of original restorations and sealing materials:

[0034] Use of the grinding device with sensor:

[0035] The doctor selects a suitable grinding device with a sensor, and adjusts the angle and speed of the grinding device according to the position and range of the restoration and resin sealing material. When grinding the restoration on the crown surface, the grinding device starts working, and the sensor monitors the grinding depth in real time. When the grinding operation approaches the safe thickness of the tooth, for example, when grinding the restoration at the neck of the tooth close to the pulp cavity, the sensor sounds an alarm, and the alarm reminds the doctor that the safety limit is currently approaching. According to the alarm, the doctor immediately adjusts the grinding force, reduces the pressure, and appropriately adjusts the grinding direction to avoid further grinding, thereby accurately removing the restoration material and minimizing damage to the tooth tissue, especially the neck of the tooth and the area close to the pulp cavity. When grinding the resin sealing material in the pulp cavity, the same operation is performed according to the alarm of the sensor to prevent grinding through the pulp cavity wall.

[0036] 1. Instruments and equipment: Grinding device with sensor. The device is mainly composed of a grinding tool head, a depth sensor, a control unit, a display unit and a power system. The grinding tool head is used to perform grinding operations on restorations and resin materials; the depth sensor can sense the grinding depth information in real time and transmit the data to the control unit; the control unit is responsible for receiving the sensor data and comparing it with the preset safety thickness data. When the warning value is reached, it sends instructions to the display unit and controls the power system to adjust the grinding force; the display unit is used to intuitively display relevant information such as the grinding depth, which is convenient for doctors to observe during operation; the power system provides power support for the grinding operation to ensure the normal operation of the grinding device.

[0037] 2. Implementation method: A specific signal (such as an ultrasonic signal or an electromagnetic induction signal, etc.) is emitted through a depth sensor. When the signal contacts the interface of different materials (tooth tissue and restoration or resin material), it will be reflected or changed. The sensor receives the reflected signal and converts it into an electrical signal and transmits it to the control unit. The control unit analyzes and processes the electrical signal according to the built-in algorithm to calculate the current grinding depth. Once the depth approaches the preset safety thickness threshold, the control unit triggers the alarm device to sound an alarm, and at the same time adjusts the output power of the power system to reduce the speed or torque of the grinding tool head, thereby achieving precise control of the grinding operation and reducing damage to tooth tissue.

[0038] 3. Detailed steps:

[0039] The doctor selects an appropriate abrasion device with a sensor according to the location and range of the restoration and resin sealing material.

[0040] According to the actual situation, accurately adjust the angle and speed of the grinding device and make preparations before grinding.

[0041] The grinding device is turned on to grind the restoration on the crown surface. At this time, the sensor is started synchronously to monitor the grinding depth in real time.

[0042] When the tooth is ground down to a safe thickness, such as when a restoration is ground down near the pulp cavity at the neck of the tooth, the sensor sounds an alarm.

[0043] When the doctor hears the alarm, he immediately reduces the grinding force and appropriately changes the grinding direction to prevent further grinding into the deep tissue, thereby accurately removing the restoration material and minimizing damage to the tooth tissue, especially the tooth neck and the area close to the pulp cavity.

[0044] When handling the resin sealing material in the medullary cavity, repeat the above steps and operate according to the sensor alarm to avoid grinding through the medullary cavity wall.

[0045] Use of new laser technology:

[0046] First, based on the previous analysis of the resin material, the doctor found that the resin material was a certain type of composite resin with moderate hardness and high polymerization degree. Based on these characteristics, the doctor set appropriate laser parameters, including the wavelength, power, pulse frequency, etc. of the laser. For example, the wavelength is set to a specific value and the power is adjusted to an appropriate level to ensure that the resin material can be effectively decomposed without causing excessive damage to the tooth tissue.

[0047] When processing crown surface restorations and intramedullary resin sealing materials, start the laser device and transmit the laser energy to the action site through optical fiber. The laser energy acts on the restorations and resin materials in a concentrated manner, causing them to decompose or vaporize rapidly. For complex restorations and resin sealing of posterior teeth, such as the presence of restorations on the distal surface of molars and their deep position, traditional grinding tools are difficult to effectively reach these areas, and the laser can easily reach these areas through optical fiber. During the laser action process, due to the precise control of parameters, the surrounding tooth tissues are less affected by heat and mechanical damage, and the temperature rise of the tooth tissues is controlled within a safe range, avoiding problems such as pulp damage and microcracks in the tooth hard tissues caused by overheating.

[0048] 1. Instruments and equipment: new laser equipment, optical fiber. The new laser equipment includes laser generator, energy regulation system, cooling system, laser transmission interface and other parts. The laser generator is responsible for generating high-energy laser beams; the energy regulation system can accurately adjust the wavelength, power, pulse frequency and other parameters of the laser to meet the processing requirements of different resin materials; the cooling system is used to dissipate the heat generated by the laser equipment during operation to prevent the equipment from overheating and damage, and it also helps to control the temperature of the tooth tissue around the laser action area; the laser transmission interface is used to connect optical fiber to transmit laser energy to the action site. As a medium for energy transmission, optical fiber can accurately transmit the energy generated by the laser equipment to the target position on the crown surface or in the pulp cavity. It has good flexibility and light conductivity, and can easily reach areas that are difficult to reach with traditional grinding tools.

[0049] 2. Implementation method: The laser generator generates a high-energy laser beam based on a specific laser generation principle (such as stimulated radiation, etc.). The energy regulation system accurately controls the wavelength, power and pulse frequency of the laser by changing the internal working conditions of the laser generator (such as current, voltage, resonant cavity structure, etc.) according to the preset parameter values. The laser beam enters the optical fiber through the laser transmission interface and is transmitted to the action site through total reflection inside the optical fiber. When the laser energy acts on the restoration and resin material, due to the high-energy characteristics of the laser, the resin material molecules absorb energy and rapidly undergo physical and chemical changes such as chemical bond breaking, sublimation or vaporization, thereby achieving material removal. At the same time, the cooling system cools the laser equipment and the surrounding environment of the action area, and the laser parameters are precisely controlled so that the heat absorbed by the tooth tissue is within a safe range, avoiding adverse consequences such as pulp damage and microcracks in the hard tissue of the tooth caused by overheating.

[0050] 3. Detailed steps:

[0051] The doctor first analyzed the resin material and determined that it was a specific type of composite resin with moderate hardness and a high degree of polymerization.

[0052] According to the characteristics of the resin material, appropriate laser parameters are set, including the laser wavelength, power, pulse frequency, etc. For example, the wavelength is set to a specific value and the power is adjusted to an appropriate level to ensure that the resin material is effectively decomposed without excessively damaging the tooth tissue.

[0053] Start the laser device, and the laser energy is transmitted through the optical fiber to the action site, the crown surface restoration and the resin sealing material in the pulp cavity.

[0054] The laser energy is concentrated on the restoration and resin material, causing them to decompose or vaporize rapidly, completing the treatment of the restoration and resin sealing material. When dealing with complex restorations and resin sealing of posterior teeth, such as molar distal restorations with deep locations, the laser can easily reach the target area with the help of optical fiber. During the entire process, due to the precise control of laser parameters, the surrounding tooth tissue is less affected by heat and mechanical damage, and the temperature increase of the tooth tissue is controlled within a safe range, effectively avoiding problems such as pulp damage and microcracks in the tooth hard tissue.

[0055] 3. Root canal cleaning and disinfection:

[0056] Rubber Dam Isolation Technique:

[0057] Choose a rubber dam of appropriate size and type, and install it around the affected tooth. Use a rubber dam clamp to fix the rubber dam on the affected tooth, ensuring that the rubber dam fits tightly against the tooth, completely isolating the affected tooth from the saliva and bacteria in the mouth. During the entire root canal re-cleaning and disinfection process, the rubber dam can effectively prevent oral bacteria and saliva from contaminating the root canal, creating a relatively sterile environment for root canal cleaning and disinfection operations, greatly reducing the possibility of root canal reinfection. For example, when cleaning the root canal, even if there are a large number of bacteria in the patient's mouth, the bacteria cannot enter the root canal due to the isolation of the rubber dam.

[0058] Use root canal disinfectant with added nanosilver particles:

[0059] After cleaning the root canal, prepare a root canal disinfectant mixed with nanosilver particles and traditional disinfectants such as calcium hydroxide paste. Mix the nanosilver particles evenly with calcium hydroxide paste in a specific ratio. The particle size of the nanosilver particles is very small, usually at the nanometer level. Use a special root canal syringe to slowly introduce the mixed disinfectant into the root canal to ensure that the drug can reach all parts of the root canal, especially the apical area. Nanosilver particles, with their small particle size, penetrate deep into the tiny structure of the root canal system and fully contact with bacteria. Its unique physical and chemical properties exert a sustained antibacterial effect and can effectively kill various bacteria, fungi and other microorganisms in the root canal, including some drug-resistant bacteria. Moreover, this antibacterial effect lasts for a long time. Compared with the use of calcium hydroxide paste alone, it can more effectively maintain the sterile state in the root canal and improve the success rate of retreatment. For example, after using this mixed disinfectant, the number of bacteria in the root canal is significantly reduced and remains at a low level for a long time.

[0060] 4. Refilling the pulp cavity and root canal:

[0061] Select new resin materials and computer color matching technology:

[0062] According to the treatment plan, biocompatible resin materials are preferred. This resin material has been tested in the laboratory and is non-irritating to the pulp tissue and periodontal tissue, and has good biocompatibility with the tooth tissue. Before filling the pulp cavity, the resin color is mixed using computer color matching technology. A special color measuring instrument is placed close to the patient's surrounding tooth tissue. The instrument uses an optical sensor to accurately analyze the color parameters of the patient's surrounding tooth tissue, including brightness, hue, saturation, etc. These parameters are then input into the computer color matching system, and the system mixes a matching resin color based on the built-in algorithm. Whether it is anterior or posterior teeth, it can ensure that the color of the restored teeth is consistent with the color of the surrounding natural teeth, improve the aesthetics of the restored teeth, and meet the patient's aesthetic needs. For example, for anterior tooth restorations, the mixed resin color is almost indistinguishable from the adjacent natural teeth.

[0063] Resin filling operation:

[0064] Self-curing resin filling: If self-curing resin is chosen for filling, the resin material is mixed on the mixing board according to strict proportions. The mixing action is quick and even to ensure that the resin components are fully mixed. After mixing, the resin is quickly filled into the medullary cavity within a limited time before it begins to solidify. Use a small filler to gently compact the resin, starting from the bottom of the medullary cavity and gradually compacting toward the crown, so that the resin is more evenly distributed in the medullary cavity and defects such as pores are avoided. For example, during the filling process, the doctor ensures that every corner of the medullary cavity is filled by adding resin in small amounts and compacting it multiple times.

[0065] Light-curing resin filling: For light-curing resin, fill the medullary cavity in layers. Use a special resin delivery tool to deliver a small amount of resin to the medullary cavity each time, and the thickness of each layer of resin should not exceed 2mm. After filling a layer of resin, use a light-curing lamp to irradiate and cure it according to the specified time and distance. For example, the wavelength and power of the light-curing lamp are set to the parameters suitable for the curing of the resin, the irradiation time is about 20-40 seconds, and the distance from the resin surface is about 1-2mm, ensuring that each layer of resin can be fully exposed to light and fully cured. Repeat this process until the medullary cavity is filled.

[0066] Root canal filling: If it is found during the inspection that the root canal needs to be re-filled, the quality of the root canal preparation must be ensured first. Use root canal files to further expand and shape the root canal. Gradually increase the file type according to the length and diameter of the root canal so that the root canal forms a continuous cone, which is conducive to the close fit of the filling material. Choose a suitable root canal filling material, such as a gutta-percha tip combined with a root canal sealer. Choose a suitable type of gutta-percha tip according to the shape and size of the root canal. The gutta-percha tip should be able to fit closely to the root canal wall and have a certain resistance inside the root canal to ensure the stability of the filling. The root canal sealer is evenly applied to the root canal wall to fill the tiny gap between the gutta-percha tip and the root canal wall, effectively sealing the root canal system and preventing bacteria from invading again.

[0067] 5. Use CBCT and CAD / CAM technology to optimize the operation process:

[0068] Application of CBCT in preoperative evaluation:

[0069] Before treatment, oral CBCT can clearly present the three-dimensional morphology of the root canal. The doctor can accurately observe the number of root canals, such as whether the affected tooth has a single root canal or multiple root canals (such as double root canals or three root canals). The curvature of the root canal can be clearly seen, such as whether the root canal is slightly curved or has a complex S-shaped curve. The length of the root canal can be determined to provide an accurate basis for root canal preparation and filling. At the same time, CBCT can also show the situation of the original filling in the root canal, determine whether the filling is complete, such as whether there is a fracture or separation of the filling, whether there is overfilling or underfilling, and the specific location and degree of overfilling or underfilling, and can also see the thickness distribution of the tooth tissue. For example, through CBCT images, it was found that the apex of a certain root canal was slightly underfilled, and the buccal tooth tissue at the neck of the tooth was thinner. These detailed information are crucial for doctors to formulate treatment plans, helping doctors to accurately determine the location of residual materials in the root canal, and can guide doctors to operate more targeted during the root canal re-cleaning process, avoiding unnecessary root canal exploration and cleaning, and reducing damage to normal tooth tissue and root canal structure.

[0070] Application of CAD / CAM technology in operation process planning:

[0071] Using CAD / CAM technology, doctors pre-plan the entire retreatment operation process based on the information obtained by CBCT. In the resin filling process, the method and thickness of resin filling can be more reasonably selected according to the conditions of tooth tissue and root canal. For example, if the root canal morphology is more complex, such as multiple bends or large changes in root canal diameter, CAD / CAM technology can help doctors design a more suitable resin filling path and thickness distribution. Through computer simulation, it is determined from which direction and in what order to fill the resin to ensure the rigor and accuracy of the filling. During the root canal preparation process, the movement trajectory of the root canal file can also be accurately controlled according to CAD / CAM planning, making the root canal preparation more accurate. Through this pre-planning, repeated attempts and unnecessary operation steps during the operation can be reduced, thereby significantly reducing the operation time and improving the efficiency of retreatment. At the same time, it can also improve the quality of treatment and reduce complications caused by operational errors or blind operations.

[0072] 6. Postoperative care and follow-up:

[0073] Postoperative medical instructions and nursing instructions:

[0074] Inform the patient of the precautions after surgery. Instruct the patient to avoid chewing hard food on the affected side in the short term after surgery (such as within one week) to prevent the restoration or filling from falling off or being damaged. Instruct the patient to maintain oral hygiene and use specific mouthwashes recommended by the doctor, such as mouthwashes containing chlorhexidine, rinsing the mouth 3-4 times a day. At the same time, teach the patient to use a soft-bristled toothbrush to brush his teeth gently to avoid damaging the gums and restorations. Inform the patient to avoid bad habits such as smoking and drinking, as these behaviors may affect local blood circulation and tissue healing in the oral cavity. For mild pain, swelling, etc. that may occur after surgery, explain to the patient that it is a normal postoperative reaction. If the pain is mild, it can be relieved by cold compressing the affected side of the face; if the pain is more obvious, take an appropriate amount of non-steroidal anti-inflammatory drugs (such as ibuprofen) as prescribed by the doctor. For swelling, inform the patient that the swelling generally reaches its peak 2-3 days after surgery and then gradually subsides. If the swelling continues to worsen or is accompanied by symptoms such as fever, a follow-up visit should be made in time.

[0075] Regular follow-up and review:

[0076] Arrange patients for follow-up at specific time intervals after surgery. The first follow-up is conducted 1 week after surgery to check the patient's oral condition, including asking the patient's subjective feelings (such as pain, swelling, etc.), observing the state of the restoration and gums, and checking oral hygiene. Follow-up is conducted again at 1 month, 3 months, 6 months, etc. after surgery. Follow-up includes oral examination and imaging examination. During the oral examination, check whether the restoration is complete, whether it is loose or discolored, whether the gums are red, swollen, bleeding, or retracted, and check the looseness of the teeth. Imaging examinations are performed by taking periapical films or CBCT (selected according to the situation) to observe the situation in the root canal, such as whether the filling is stable, whether there are new periapical lesions, and the healing of the surrounding alveolar bone. According to the follow-up results, possible problems should be discovered and dealt with in a timely manner, such as resin microleakage, recurrence of periapical inflammation, etc., and the subsequent treatment or care plan should be adjusted in a timely manner.

[0077] 7. Emergency treatment during surgery:

[0078] Emergency treatment of pulp cavity perforation:

[0079] If pulp cavity perforation occurs during the removal of the original restoration and sealing materials or the root canal re-cleaning process, the doctor should stop the operation immediately. Use normal saline to rinse the perforated area and rinse away debris, blood, etc. from the wound. For smaller perforations, such as perforations with a diameter of less than 1 mm, you can try to use a restorative material with good biocompatibility (such as MTA) for immediate repair. Mix the MTA material into a paste according to the prescribed water-powder ratio, use a special delivery tool to accurately deliver it to the perforated area, and then gently compact it to ensure that the material completely covers the perforation and fits tightly with the surrounding tooth tissue. For larger perforations (such as those with a diameter greater than 1 mm), the treatment plan needs to be changed. Depending on the location of the perforation and the specific condition of the affected tooth, a pulpotomy may be required or extraction of the affected tooth may be considered (when other treatments cannot effectively repair it). At the same time, give the patient appropriate anti-infection treatment, such as oral antibiotics, to prevent the spread of infection.

[0080] Emergency treatment of broken instruments:

[0081] If an instrument such as a root canal file breaks in the root canal during the root canal re-cleaning process, first determine the location and length of the broken instrument through X-rays or CBCT. If the broken instrument is located in the crown of the root canal and can be directly removed, it can be removed using an ultrasonic instrument or a special root canal instrument removal device. Adjust the working tip of the ultrasonic instrument to the appropriate frequency and power, and gently vibrate the position near the broken instrument in the root canal to loosen the broken instrument and then remove it; or use a special instrument removal device to clamp the broken instrument and pull it out through its special design. If the broken instrument is located in the middle or apical part of the root canal, evaluate its impact on root canal treatment. If it does not affect root canal filling and prognosis, it can be considered as part of the root canal filling. If it affects the treatment effect, such as hindering root canal filling or possibly causing periapical inflammation, it is necessary to consider using more complex treatment methods such as micro-root canal surgery to accurately remove the broken instrument under a microscope.

[0082] 8. Pain management:

[0083] Optimization of local anesthesia:

[0084] According to the location of the affected tooth and the patient's pain threshold, choose the appropriate local anesthesia method and anesthetic drugs. For maxillary anterior teeth, local infiltration anesthesia can be selected, using lidocaine anesthetic drugs containing epinephrine, which can reduce intraoperative bleeding and prolong the anesthesia time. For areas with complex pulp nerve distribution such as mandibular molars, conduction anesthesia can be used, such as the use of drugs with good anesthetic effects such as articaine. For patients with pulp vitality or sensitive to pain, surface anesthetics (such as tetracaine gel) can be used on the surface of the affected tooth before treatment to assist infiltration anesthesia or conduction anesthesia, improve the anesthesia effect, and reduce the patient's pain during treatment. During the anesthesia process, pay attention to the correct injection technique, such as choosing a suitable needle insertion point to avoid damaging surrounding tissues and causing unnecessary pain. Push the anesthetic slowly during the injection, and closely observe the patient's reaction.

[0085] Intraoperative pain control:

[0086] During the operation, if the patient still feels pain, the dose of local anesthetics can be appropriately increased or the type of anesthetics can be changed within a safe range. For example, if lidocaine anesthesia is not effective, long-acting anesthetics such as bupivacaine can be considered. At the same time, the doctor should operate gently to avoid excessive stimulation of the pulp and periodontal tissues. When using root canal instruments for root canal cleaning and preparation, control the entry depth and force of the instruments to prevent the instruments from exceeding the apical foramen and stimulating the periapical tissues. For patients with more severe pain, oral or intravenous analgesics can be considered during treatment, but attention should be paid to the effects of the drugs on the patient's systemic condition and possible adverse reactions. For example, non-steroidal anti-inflammatory drugs may irritate the gastrointestinal tract and should be used with caution.

[0087] Postoperative pain prevention and treatment:

[0088] After the treatment, analgesic drugs (such as clove oil cotton balls) can be placed in the pulp cavity to relieve the pain reaction of the pulp after surgery. Inform the patient of the pain that may occur after surgery and how to relieve it. For example, the pain usually begins within a few hours after surgery, may be more obvious within 1-2 days, and then gradually subsides. For patients with obvious postoperative pain, oral nonsteroidal anti-inflammatory drugs or other analgesics, such as acetaminophen, can be given according to the degree of pain. If the pain persists or worsens, such as pain for more than 3 days and gradually worsens, or accompanied by fever, swelling and other symptoms, the patient should be arranged for a follow-up examination in time to determine whether there is infection or other complications.

[0089] It should be noted here that the intelligent design monitoring platform is combined with oral CBCT (cone beam CT) technology in a fixed tooth detector to detect: changes in the relative position angle between the sensor's grinding device and the working surface, and between the laser generator and the working surface, to further improve the accuracy of removing crown surface restorations and intramedullary resin sealing materials, and can safely handle complex restorations and resin sealing situations, further improving treatment safety and accuracy.

Claims

1. A method for resin sealing retreatment of the medullary cavity after root canal treatment, characterized in that: The following steps are involved: S1: preoperative sampling; S2: Removal of restorations and other materials: Use material removal techniques and tools to remove crown surface restorations and intramedullary resin sealing materials, where material removal techniques and tools include abrasive devices with sensors or laser technology; the sensor is a depth sensor, and the emitted signal will be reflected or changed when it contacts the interface of different materials; in laser technology, the laser generator generates a high-energy laser beam, which causes the resin material molecules to absorb energy and undergo physical and chemical changes such as chemical bond breaking, sublimation or vaporization, thereby achieving material removal; S3: Root canal re-cleaning and disinfection: Rubber dam isolation technology is used during the root canal re-cleaning and disinfection process, and root canal disinfection drugs with added nanosilver particles are used after the root canal is cleaned. Nanosilver particles are mixed with traditional disinfection drugs such as calcium hydroxide paste; S4: Re-filling treatment: In the process of re-filling the pulp cavity and root canal, biocompatible resin materials should be used first. Before filling the pulp cavity, the color of the resin should be adjusted using computer color matching technology. For self-curing resin and light-curing resin, filling should be performed according to the prescribed operation. If re-filling of the root canal is required, the quality of the root canal preparation should be ensured and the appropriate root canal filling material should be selected; It also includes: Intelligent design monitoring platform: use oral CBCT (cone beam CT) and computer-aided design / computer-aided manufacturing (CAD / CAM) technology to evaluate the affected teeth and plan the operation process before treatment; provide medical advice and nursing guidance to patients after surgery and arrange regular follow-up and reexaminations, and at the same time have intraoperative emergency treatment and pain management measures during the treatment process.

2. A method for re-treatment of the intramedullary cavity with resin sealing after root canal treatment according to claim 1, characterized in that: In S1, the patient's medical history was collected and analyzed, oral examination and imaging review were performed, and psychological counseling and informed consent were obtained; Included in the steps of history collection and analysis is detailed questioning of the patient's root canal treatment history, general health status and allergy history, analysis of information to assess the risk of retreatment and special preparation needs, oral examination and imaging review including a comprehensive examination of the affected teeth and adjacent teeth and a variety of imaging examinations, and determination of indications, contraindications and treatment plans based on the results, and patient psychological counseling and informed consent is to explain the treatment process and situation to the patient and ensure that he understands and signs the consent form.

3. A method for re-treatment of the intramedullary cavity with resin sealing after root canal treatment according to claim 1, characterized in that: In S2, the grinding device with a sensor sends out an alarm when it approaches the safe thickness of the tooth during the grinding process. The doctor adjusts the operating parameters accordingly to reduce damage to the tooth tissue, especially the tooth neck and the area near the pulp cavity. The new laser technology sets parameters according to the characteristics of the resin material to reduce the thermal impact and mechanical damage to the surrounding tooth tissue in order to handle complex restorations and resin sealing situations.

4. A method for re-treatment of the intramedullary cavity with resin sealing after root canal treatment according to claim 1, characterized in that: In S3, the rubber dam isolation technology completely isolates the affected tooth from the saliva and bacteria in the oral cavity, creates a relatively sterile environment for root canal cleaning and disinfection operations, and reduces the possibility of root canal reinfection. The nanosilver particles, with their small particle size, penetrate deep into the tiny structure of the root canal system and exert a sustained antibacterial effect.

5. A method for retreatment of intramedullary cavity resin sealing after root canal treatment according to claim 1, characterized in that: In S4, the color of the resin is mixed using computer color matching technology before filling the pulp cavity. The color parameters of the patient's surrounding tooth tissue are accurately analyzed to match the mixed resin color with the surrounding tooth tissue, thereby improving the aesthetics of the restored teeth. Self-curing resin and light-curing resin are filled according to corresponding operations, and the quality of root canal preparation and the selection of appropriate materials are ensured when re-root canal filling.

6. A method for retreatment of intramedullary cavity resin sealing after root canal treatment according to claim 1, characterized in that: In S5, oral CBCT (cone beam CT) and computer-aided design / computer-aided manufacturing (CAD / CAM) technology are used to evaluate the affected tooth and plan the operation process before treatment, and unnecessary operation steps are reduced through CAD / CAM technology based on the CBCT display information.

7. A method for re-treatment of intramedullary cavity with resin sealing after root canal treatment according to claim 1, characterized in that: In the intelligently designed monitoring platform, postoperative medical instructions and nursing guidance include informing patients to avoid chewing hard food on the affected side, maintaining oral hygiene, avoiding bad habits, and explaining methods to alleviate postoperative reactions. Regular follow-up and review include performing oral and imaging examinations at specific time intervals and addressing any problems found.

8. A method for retreatment of intramedullary cavity resin sealing after root canal treatment according to claim 1, characterized in that: In the intelligent design monitoring platform, intraoperative emergency treatment includes treatment methods for pulp cavity perforation and root canal instrument fracture, and pain management includes selection of appropriate anesthesia methods and drugs, intraoperative and postoperative pain control and treatment measures.

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