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

Autor: Villa-Machado PA; Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia., Restrepo-Restrepo FA; Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia., Tobón-Arroyave SI; Graduate Endodontics Program, Faculty of Dentistry, University of Antioquia, Medellín, Colombia.
Jazyk: angličtina
Zdroj: International endodontic journal [Int Endod J] 2024 Apr; Vol. 57 (4), pp. 490-500. Date of Electronic Publication: 2024 Jan 20.
DOI: 10.1111/iej.14026
Abstrakt: Aim: Endodontic microsurgery (EMS) of maxillary molars may represent a complex challenge to the clinician due to the location of the roots and the proximity of the maxillary sinus floor. This report aimed to describe the simultaneous use of a computer-assisted dynamic navigation (C-ADN) system and piezoelectric bony-window osteotomy for the transantral microsurgical approach of a maxillary left first molar with adequate root canal filling and symptomatic apical periodontitis.
Summary: This case report highlights the importance of C-ADN to carry out a minimally invasive buccal surgical access to palatal roots affected by apical periodontitis and provides a practical example to help clinicians make treatment decisions based on the available evidence. Clinical and tomographic evaluations were performed before the surgical procedure and at 24-month follow-up. This case was treated using a C-ADN system fitted to a piezotome for the buccal approach of the buccal roots, maxillary sinus membrane lifting, and for transantral location, root-end resection, cavity preparation, and filling of the palatal root. The navigation system allowed to achieve an accurate apical canal terminus location and root-end filling of the three roots with a minimally invasive piezoelectric crypt approach. At the 24-month follow-up examination, the patient remains asymptomatic, with normal periapical structures, and regeneration of maxillary sinus walls. It was concluded that the combination of dynamic navigation with piezoelectric bony-window osteotomy offers enhanced accuracy, tissue preservation, diminished risk of iatrogenic complications, and could maximize success and survival rates in transantral EMS.
(© 2024 British Endodontic Society. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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