Assessment of guided versus non-guided endodontic microsurgery with root-end resection using different retrograde...

Guided microsurgery has been proposed to improve precision and reduce operation time, but its effect on bone healing remains unclear.

To compare guided microsurgical root end resection and different retrograde filling materials versus non-guided endodontic microsurgery on operation time and lesion bone volume using cone-beam computed tomography (CBCT).

24 patients undergoing apicoectomy for anterior maxillary teeth were selected according to inclusion and exclusion criteria. Then they were randomly divided into two groups: Group A, receiving endodontic microsurgery without a surgical guide (n = 12), and Group B, utilizing a surgical guide (n = 12). Each of these groups was further subdivided into two smaller groups of six, based on the retrograde filling material used: Subgroup S1 for mineral trioxide aggregate (MTA)-Angelus and Subgroup S2 for Well-Root Putty. Operation time was recorded intraoperatively. Lesion volume was assessed using CBCT scans taken 1 week and 6 months after surgery. Data were analyzed statistically to evaluate differences among the groups.

The guided group showed a significantly shorter operation time (26-27.5 min) compared with the non-guided group (39-47 min), with no significant difference between retrograde filling materials. All groups exhibited a significant reduction in lesion volume at 6 months, with no significant intergroup differences.

guided microsurgery effectively reduced surgical time but had no impact on bone lesion volume. MTA-Angelus and Well-Root Putty showed comparable clinical performance.