International Journal of Chemical and Biochemical Sciences (ISSN 2226-9614)[/vc_column_text][/vc_column][/vc_row]
VOLUME 26(20) (2024)
Minimally Invasive Single-Step Computer-Guided Endodontic Microsurgery: A Case Report
1Amira Hassan Rashad, 2Hossam El-Dien Hany, 3Tariq Yehia, 4Abeer Abdel hakim El Gendy
1Teaching Assistant of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
2Lecturer of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
3Associate Professor of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
4Professor of Endodontics, Faculty of Dentistry, Ain Shams University, Cairo, Egypt
Abstract
A major challenge in daily endodontic practice is when conventional treatment fails, and the endodontist has to shifts for surgery. Endodontic surgery entails precisely locating the root-end, this is challenging in cases with closed lesions, and high risk with cases having proximity to vital structures such as maxillary sinus or mental foramen, Cases with deeply seated palatal roots that require access from labial surface also represent a major challenge. Additionally, minimizing the osteotomy size has been correlated with a favorable postoperative course. Hence, a technique that involves osteotomy and root resection in a single step using a trephine bur through a three-dimensionally printed surgical guide is of great promise to minimize vital tissue injury, shorten the procedural time, minimizing bone removal and providing rapid as well as better healing. Here, that technique was successfully used on a patient reporting severe pain on percussion after failed conventional root canal treatment of an upper premolar, where radiographic examination showed transportation and apical perforation in the palatal root. The case was failed to be managed conventionally to negotiate the apical part of the canal. Endodontic surgery was planned where only the palatal root-end was resected through a buccal approach to avoid compromising the tooth support by resecting both roots. Postoperative cone beam computed tomography confirmed the successful surgery and the appropriate planning. The surgical guide was able to accurately transfer the virtual plan to the operation theatre. It is therefore shown that endosurgery in critical areas can be accurately accomplished using targeted endodontics.
Keywords: Image guided surgery, minimally invasive surgical procedures, endodontics, and microsurgery.
Full length article *Corresponding Author, e-mail: dr.amirahassan2012@gmail.com https://doi.org/10.62877/33-IJCBS-24-26-20-33