Dynamically guided transantral piezoelectric endodontic microsurgery: A case report with technical considerations.

Area of Science:

• Dentistry
• Endodontics
• Surgical Technology

Background:

• Endodontic microsurgery (EMS) on maxillary molars presents challenges due to root anatomy and sinus proximity.
• Symptomatic apical periodontitis in maxillary molars requires advanced surgical techniques for effective treatment.

Observation:

• A case report details the simultaneous use of computer-assisted dynamic navigation (C-ADN) and piezoelectric bony-window osteotomy.
• The procedure involved a transantral microsurgical approach for a maxillary left first molar with apical periodontitis.

Findings:

• C-ADN guided minimally invasive buccal access and transantral procedures, including root-end resection and filling of the palatal root.
• The navigation system ensured accurate localization of the apical canal terminus and root-end filling for all three roots.
• At 24-month follow-up, the patient was asymptomatic with regenerated periapical structures and maxillary sinus walls.

Implications:

• The combination of C-ADN and piezoelectric surgery offers enhanced accuracy and tissue preservation in transantral EMS.
• This technique minimizes iatrogenic complications, potentially maximizing success and survival rates for complex endodontic microsurgeries.
• The findings provide valuable insights for clinicians considering advanced treatment options for maxillary molar endodontic issues.