Accuracy of Surgical Guides in Guided Apical Surgery: An In Vitro Comparative Study

Area of Science:

• Dentistry
• Surgical Technology
• Endodontics

Background:

• Guided endodontic microsurgery offers improved safety and precision over freehand techniques.
• Stereolithographic surgical guides are increasingly used in dental procedures.
• Digital planning software aids in creating precise surgical guides.

Purpose of the Study:

• To evaluate the accuracy, stability, and operative time of trephinations using stereolithographic surgical guides.
• Compare Exoplan and Blue Sky Plan software against the conventional freehand technique.
• Assess the clinical potential of digital guides in endodontic microsurgery.

Main Methods:

• Comparative in vitro study on 72 roots from 12 mandibles.
• Superimposition of cone-beam computed tomography (CBCT) and intraoral scans for guide design.
• Trephinations performed using freehand, Blue Sky Plan, and Exoplan guided techniques.

Main Results:

• Exoplan showed superior accuracy with 0.17 mm deviation.
• Exoplan demonstrated significantly better stability with 12.5% failures compared to 50% for Blue Sky Plan.
• Exoplan achieved the shortest operative time (106 s) versus Blue Sky Plan (127 s) and freehand (155 s).

Conclusions:

• Exoplan-guided trephinations outperformed Blue Sky Plan and freehand techniques in stability, accuracy, and efficiency.
• Digital guides show promise for enhancing safety and predictability in endodontic microsurgery.
• Further clinical validation is necessary to confirm these findings in practice.