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Updated: Jan 7, 2026
Guided Endodontics: Three-Dimensional Planning and Template-Aided Preparation of Endodontic Access Cavities
Published on: May 24, 2022
Two- and three-dimensional evaluation of endodontic microsurgery outcomes in maxillary anterior teeth with
1Department of Endodontics, Suzhou Stomatological Hospital, No. 1366 Suzhan street, Suzhou, 215005, China.
Objective:
This retrospective cohort study evaluated healing outcomes following endodontic microsurgery (EMS) in maxillary anterior teeth with through-and-through periapical lesions (PALs) using periapical radiographs and cone-beam computed tomography (CBCT).
Methods:
Permanent teeth with through-and-through PALs treated by EMS and followed for more than 24 months were included. Two calibrated endodontic specialists independently assessed two-dimensional (2D) healing according to the Molven criteria and three-dimensional (3D) healing using the PENN 3D criteria. Treatment outcomes were dichotomized as success (complete and incomplete/limited healing) or failure (uncertain and unsatisfactory healing). Preoperative and follow-up lesion volumes were calculated using Mimics software.
Results:
Sixteen patients (22 teeth, 16 through-and-through lesions) with a follow-up period ranging from 24 to 61 months (mean, 33 months) were included. Complete healing was observed in 62.5% of cases according to the 2D criteria and in 31.3% according to the 3D criteria. The mean lesion volume significantly decreased from 856.97 ± 566.06 mm³ preoperatively to 95.74 ± 180.45 mm³ at follow-up (P < 0.0001).
Conclusions:
Favorable healing outcomes were observed following EMS in maxillary anterior teeth with through-and-through lesions. CBCT-based assessment applied more stringent healing criteria than periapical radiographs and provided a more comprehensive evaluation of periapical bone regeneration.
