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Three-dimensional Assessment of Healing Variability after Endodontic Microsurgery Using the Bone Lid Technique: A
Su-Min Lee1, Jayden D Kwak2, Alex Ruch3
1Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.
Journal of Endodontics
|September 14, 2025
Summary
The bone lid technique in endodontic microsurgery shows potential for improving cortical bone healing. Maintaining bone lid stability is crucial for successful outcomes in molar apical lesion treatment.
Area of Science:
- Oral surgery
- Endodontics
- Regenerative medicine
Background:
- Cortical bone healing after endodontic microsurgery for apical lesions can be challenging.
- The bone lid technique aims to improve surgical access and minimize bone loss.
Purpose of the Study:
- To evaluate the efficacy of the bone lid technique in promoting cortical bone healing after endodontic microsurgery.
- To assess factors influencing bone lid integration and healing outcomes.
Main Methods:
- A case series involving 6 patients with intact buccal cortical bone (>1 mm) undergoing endodontic microsurgery.
- Bone lids were created using a piezotome, preserved, and repositioned with a collagen matrix.
- Healing assessed via 3D cone beam computed tomography and bone lid integration perimeter.
Main Results:
- Complete healing observed in 2 out of 6 cases.
- Limited cortical plate healing in one case; bone lid dislodgement occurred in two cases.
- Bone lid integrity was identified as a critical factor for successful outcomes.
Conclusions:
- The bone lid technique may facilitate favorable cortical healing in endodontic microsurgery.
- Postoperative stability and bone lid integrity are essential for successful outcomes.
- Further research is needed to optimize this technique for predictable healing.
