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A Novel Prefabricated Grid for Guided Endodontic Microsurgery.

Yuehong Fan1, Gerald N Glickman1, Mikhail Umorin2

  • 1Department of Endodontics, Texas A&M College of Dentistry, Dallas, Texas.

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|March 17, 2019
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Summary

Guided endodontic microsurgery using cone-beam computed tomography (CBCT) and prefabricated grids significantly improves apical access accuracy. This novel grid-based method offers a more precise approach compared to traditional nonguided techniques.

Keywords:
Apicoectomygridguided surgerysurgical endodontic treatment

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Area of Science:

  • Endodontics
  • Oral Surgery
  • Radiology

Background:

  • Endodontic microsurgery requires precise apical access.
  • Current methods for guiding this access can be limited in accuracy.
  • A novel approach using cone-beam computed tomographic (CBCT) imaging and prefabricated grids is proposed.

Purpose of the Study:

  • To introduce and evaluate a novel CBCT-guided method for apical access in endodontic microsurgery.
  • To compare the accuracy of this grid-based guided method against a traditional nonguided approach.

Main Methods:

  • Forty-two human cadaver roots were used, with 21 in the experimental (grid-based) group and 21 in the control (nonguided) group.
  • Preoperative CBCT images guided the design of the drill path.
  • Prefabricated metal grids served as references during imaging and surgery.
  • Postoperative CBCT assessed the deviation between actual drill paths and target points.

Main Results:

  • The grid-based method showed a significantly smaller mean deviation (0.66 mm ± 0.54 mm) compared to the nonguided method (1.92 mm ± 1.05 mm) (P < .001).
  • Guided drilling was on average 1.27 mm closer to the target.
  • The success rate for drilling was significantly higher with the grid-based method (P = .02).

Conclusions:

  • The proposed CBCT-guided method using prefabricated grids is significantly more accurate for apical access in endodontic microsurgery.
  • This technique offers improved precision and a higher success rate compared to nonguided methods.