Priyanka et.al.

UJMDS 2020, 08 (02): Page 16-19

ISSN 2347-5579

Unique Journal of Medical and Dental Sciences

Available online: www.ujconline.net
Review Article

MICROROBOTICS IN ENDODONTICS – A REVIEW

Priyanka R1*, Borthakur Bikash Jyoti2, Ganesan S3, Swathika B3
1
Junior resident, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Gorimedu, Puducherry, India
2
Professor and Head, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences,
Gorimedu, Puducherry, India
3
Professor, Department of Conservative Dentistry and Endodontics, Mahatma Gandhi Post Graduate Institute of Dental Sciences, Gorimedu, Puducherry, India

Received 30-04-2020; Revised 28-05-2020; Accepted 26-06-2020

DOI: 10.46791/UJMDS.2020.080204
*Corresponding Author: Dr. Priyanka R
Junior Resident, Dept of Conservative Dentistry and Endodontics, Mahatma Gandhi Postgraduate Institute of Dental Sciences, Gorimedu, Puducherry- 605006
Email: rpriyanka934@gmail.com

ABSTRACT
The Robotic technology brought about successful revolution in the field of medicine, especially in the branch of surgery. Though,
there is minimal exploration of the same in the field of dentistry, still it offers a promising future. This involves dental training robots,
realistic human like robots, endo microrobots, surgical robots, sensor equipped implant setup robots, etc., Endodontic therapy is time
consuming and prone for human errors like perforation, ledging, transportation, stripping, over instrumentation, inadequate canal
preparation. The outcome mainly relies on clinician’s skill, which is gained through years of training and practice. To overcome these
problems, a Visual guided robotic system - Endodontic Microrobots were developed, which is mounted on the teeth in patients mouth,
connected to the computer with robotic controller and root canal image processor to perform automatic treatment procedures including
probing, access opening, cleaning, shaping and obturation, thereby, improves the treatment quality, accuracy and efficiency. This
article presents the invention, mechanical design and mechanism of action of the intelligent microrobots, for endodontic therapy and
describes how the modern science and technology, brings about a new frontier in the field of endodontics.
Keywords: Endodontic Microrobots, Visual guided, Computer Numerical Control (CNC), Silicon-on-insulator (SOI), Actuator,
Controller.

of the root canal4. By using an endo access bur attached to a

INTRODUCTION
In 1921, Czech Playright Karel Capek coined the term Robot,
in his play Rossom’s Universal Robots. In 1950, the term
robotics was introduced by writer Isaac Asimov in his science
fiction book, I Robot1. In 1954, George Devol, invented first
digitally operated and programmable robot.
MICROROBOTICS are related to robots that are able to
handle objects and carry operations at the micrometre range2.
Endodontic treatment is carried to prevent the tooth from
being a source of infection. Typically, endodontic treatment
involves root canal preparation and root filling. The root canal
preparation, preparing the root canal for root filling, can be
divided into three phases:
(1) access preparation,
(2) coronal canal preparation, and
(3) apical canal preparation3.
The goal of endodontic access preparation is to create an
unimpeded pathway to the pulpal space and the apical portion
high-speed turbine hand-piece, the pulp chamber is deroofed,
and canal orifices are located. In order to procure a good
instrument control, the straight-line access to the apical
portion of the root canal should be obtained during access and
coronal canal preparation5. Successful cleaning establishes the
use of instruments to physically remove substances, irrigating
systems to flush loosened materials away, and chemicals to
dissolve contents from inaccessible regions. The Root canal
shaping is a mechanical process performed with instruments,
in order to establish a continuous conical form from coronal to
apical to facilitate filling of the root canals with gutta-percha
cones and sealer that are today’s most commonly used filling
materials6.
The problems identified cannot be resolved solely by training
the clinicians. There is a need for advanced endodontic
technology innovation by applying advanced engineering
concepts and computer aided technology to reduce the

Unique Journal of Medical and Dental Sciences 08 (02), April-June 2020 16

 Priyanka et.al. UJMDS 2020, 08 (02): Page 16-19
potential for human error and improve the quality of care
during endodontic therapy7.
The Advanced Endodontic Technology Development project
was proposed by Dr. Hong Seok, professor at Columbia
University in the United States. This project has been
introduced with a goal of developing a computer aided treating
system and an intelligent miniature robot which can perform
endodontic treatment automatically7.
OBJECTIVES FOR MICRO ROBOT DESIGN
(1) Reliance on the skills of the dentist is reduced,
(2) Minimizing human error,
(3) Offering a method for precise diagnosis and treatment8.
SPECIFICATIONS AND REQUIREMENTS

Compact machine size- 20mm x 20mm x 28mm

Should be able to provide a thrust force not less than 500g
(4.9 Newtons) for the penetration of tool into the crown
and dentin.

Rotational power to drive the tool at speed and torque on
par as used in endodontic treatment tools;

Micro position and orientation adjustment

Automatic feed rate and travel distance control to reach
required canal depth and stop at designated point.

Built-in micro sensors to monitor the probing and
drilling/reaming process;

Apex sensing and control to prevent root perforations

Flexible drills or files

Vacuum attachments capable of sucking the debris or
loose tissue
PROCEDURE [ Figure 1]:
1) 2-dimensional x-ray images to build a computer 3-D
tooth model,
2) Development of an automatic prescription system,
Computer Numerical Control (CNC) from the 3-D
root canal model, using computer aided treatment
procedure planning 9,10.
3) Design of built -in smart non-destructive, multi-
purpose precision micro machine to perform
automated root canal drilling and filling.
4) Development of a new ultrasonic cleaning tool with
pressure assisted jetting/vacuum waste removal.
Figure 1.1
Figure 1.2
Unique Journal of Medical and Dental Sciences 08 (02), April-June 2020
Figure 1.3
Figure 1
Source: [1] https://www.researchgate.net/figure/Intraoral-pre-
operative- radiograph-showing-well- defined-radiolucency-
of-mesial-and-distal_
[2]http://agadirdentalcenter.com/endodontie/
[3] http://cerev.info/addzthis-endo.comstudy.htm
MECHANICAL DESIGN
There are various different machine configurations. The three
design concepts were projected and compared to determine
which one satisfies the engineering characteristics. The first
design is a Cartesian-style robot where the robot sits mainly
on the arch of teeth, which the tooth undergoing treatment is
located. Each of the X- and Y- axes of motion is controlled by
a pair of rods that are threaded to accommodate a nut that
would be spun at a stationary location to extend the threaded
rod. The independent control of each rod would control the
degree of tilt needed to angle the end effector towards the root
canal opening. The Z-axis would be controlled by a rack-and-
pinion design that would raise and lower the end effector into
the tooth cavity7.
The second is also Cartesian-style, with the actuators sitting
off the teeth. The motion of the tool is controlled much the
same way as the first concept, with independently controlled
threaded rods. The final concept shows a cylindrical style
robot that also sits off the tooth line. Rather than working on
an X-Y coordinate system, the third concept uses a polar
coordinate system to position the end effector. The large,
cylindrical object rotates to the correct angle to place the
radial arm in line with the drill site, while the arms are
lengthened or shortened to bring the tool into proper position.
The tool angle would then be controlled by independently
lengthening or shortening the radial arms7.
MOVEMENT OF MICROROBOT
The Micro robot has five axes of motion : linear motion in the
X, Y, Z directions, and rotational motion in θ x, θ y
directions7.To provide an accurate positioning of the tool, with
correct angular orientation, an ideal basic machine must have
five degrees of freedom to control the following axes as
follows:
1) X-axis, along the teeth row, with 5 mm stroke
2) Y-axis, over the teeth row, with 4 mm stroke
3) Z-axis, the tool advancement direction, perpendicular to
the tooth occlusal surface, with a stroke of minimum 15 mm
for a shorter tool and 28mm for a longer tool
4) Tool entrance angle of ± 12° in the X-Z plane
5) Tool entrance angle of ± 12º in the Y-Z plane.
The machine has a saddle-shaped base. It will ride on a pair of
reference brackets and the teeth row12. [Figure 2]
17
 Priyanka et.al. UJMDS 2020, 08 (02): Page 16-19

The clinician is provided with a manual remote for control of

microrobot operation. However, a fully automatic operation
with computer-aided
aided treatment procedure planning and control
is the ultimate goal for a zero-defect
defect operation. An interface
system will be provided for the clinician to interact with the
machine control12.
FUTURE WORK
In future, the hand held endo motor torque system will be
replaced by a tactile haptic robotic device, in order to realize
the fully automated force feedback system integrated with the
vision based micro robotic control.
control
CONCLUSION
Figure 2A
The triumphant manufacturing and integration of microrobots
into the Advanced Endodontic Technology Development
Developme plan
will change the traditional way of root canal treatment to
complete science and technology-based
technology automation, and lead
the microelectronic biomedical technology into a new era in
endodontics.
REFERENCES
1. Rawtiya M, Verma K, Sethi P, Loomba K.
Application
ation of robotics in dentistry. Indian J Dent
Adv. 2014 Oct 1;6(4):1700-6.
1;6(4):1700
2. D’Souza RD, Sharma S, Pereira AJ, Hashimi AA.
Microrobotics: Trends and technologies. American J
Eng Res 2016; 5(5):32-39.39.
Figure 2B
3. West JD, Roane JB. Cleaning and shaping the root
canal system.
tem. In Cohen S, Burns RC, editors:
Pathways of the Pulp, ed 7, St Louis, Missouri, The
C.V. Mosby 1997:203257.
4. Gutmann JL and Lovdahl PE: Problems Encountered
in Tooth Isolation and Access to the Pulp Chamber
Space. In Gutmann JL, Dumsha TC, Lovdahl PE,
Hovland EJ, editors: Problem Solving in
Endodontics-Prevention,
Prevention, Identification, and
Management,, ed 3, St Louis, Missouri, The C.V.
Mosby, 1997, pp47-67.
5. Walton, Richard E.: Torabinejad Mahmoud:
Principles and Practice of Endodontics, Third edition,
W.B.Saunders Company, 2002, pp192-197.
pp192
6. Gutmann JL, Dumsha T: Cleaning and Shaping the
Figure 2C Root Canal System. In Cohen S, Burns RC, editors:
Pathways of the Pulp,, ed 7, St Louis, Missouri, The
MICRO SENSORS, ACTUATORS, & CONTROLLERS C.V. Mosby Company, 1997, pp160-173.
pp160
This machine design also includes sensors for intelligent 7. J.Dong, S. Hong, and G. Hesselgren.
Hessel A study on
monitoring of the treatment process. These sensors are development of endodontic microrobot, presented at
fabricated using a surface micro machine method to produce the 2006 IJME – Intertech Conference, Kean
silicon-on-insulator (SOI) wafers, which is incorporated in the University, Union, NJ, 1996-
1996
micro robot11. It consists of six micro actuators, which http://ijme.us/cd_06/PDF/ENT%20104-110.pdf-
http://ijme.us/cd_06/PDF/ENT%20104
administer the movement of the five axes (five degrees of accessed on 24th Sep 2016.
freedom) and turn on/off the spindle of the tool. Each actuator 8. Mittal S, Kumar T, Mittal S, Sharma J. Endodontics
Endodo
is independently controlled by a digital CNC controller. In a generation next - Microrobotics-
Microrobotics Review. Dent J Adv
few milliseconds, the controller reacts to the sensor input Studies 2013; 1(1):43-45.
45.
quickly. Computer aided design generates CNC codes (G 9. Gulrez T, Shahid AK, Sana U, Chaudhary NG.
codes and M codes) as output from a computer aided design Visual guided robotic endodontic therapeutic
file. These codes control the movements of the robot ththrough system. In2010 International Conference on
an CNC digital controller12.

Unique Journal of Medical and Dental Sciences 008 (02), April-June 2020 18
 Priyanka et.al. UJMDS 2020, 08 (02): Page 16-19

Information and Emerging Technologies 2010 Jun 14 devices, Artech House 2009:10.
(pp. 1-6). IEEE http://us.artechhouse.com/ Nanomedicine-Design-of-
10. Dong J: Rule-based Planning for Automated Particles-Sensors-Motors-Implants- Robots-and-
Endodontic Treatment - From Dental Radiography, Devices-P1265.aspx- accessed on 24th Sep 2016.
3-D Computer Modeling, to Tool Selection and Path 1. Neha.S et al. Micro Robot-A Revolution in
Control, Dissertation, Columbia University, 2003, Endodontics. Annals of Int. Med and Dent. Res.2017
pp149-153, pp18-47, pp216-230. Apr; (03):6-8.
11. Schulz MJ, Shao VN, Yun Y. Nanomedicine design
of particles, sensors, motors, implants, robots, and

Source of support: Nil, Conflict of interest: None Declared

Unique Journal of Medical and Dental Sciences 08 (02), April-June 2020 19