Anderson J, Wealleans J, Ray J. Endodontic applications of 3D printing. International Endodontic Journal.Computer-aided design (CAD) and computer-aided manufacturing (CAM) technologies can leverage cone beam computed tomography data for production of objects used in surgical and nonsurgical endodontics and in educational settings. The aim of this article was to review all current applications of 3D printing in endodontics and to speculate upon future directions for research and clinical use within the specialty. A literature search of PubMed, Ovid and Scopus was conducted using the following terms: stereolithography, 3D printing, computer aided rapid prototyping, surgical guide, guided endodontic surgery, guided endodontic access, additive manufacturing, rapid prototyping, autotransplantation rapid prototyping, CAD, CAM. Inclusion criteria were articles in the English language documenting endodontic applications of 3D printing. Fifty-one articles met inclusion criteria and were utilized. The endodontic literature on 3D printing is generally limited to case reports and pre-clinical studies. Documented solutions to endodontic challenges include: guided access with pulp canal obliteration, applications in autotransplantation, pre-surgical planning and educational modelling and accurate location of osteotomy perforation sites. Acquisition of technical expertise and equipment within endodontic practices present formidable obstacles to widespread deployment within the endodontic specialty. As knowledge advances, endodontic postgraduate programmes should consider implementing 3D printing into their curriculums. Future research directions should include clinical outcomes assessments of treatments employing 3D printed objects.

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Hawkins TK, Wealleans JA, Pratt AM, Ray JJ. Targeted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison. International Endodontic Journal, 53, 715-722, 2020.Aim To compare surgical time, bevel angle and site volumetric profiles of osteotomy and resection accomplished by targeted endodontic microsurgery (TEMS) and traditional endodontic microsurgery (EMS) in a surgical simulation model. Methodology An 80x80-mm cone beam computed tomography (CBCT) file was imported into Mimics software where artificial periapical lesions were created encompassing twelve root apices. Maxillary and mandibular models were 3D-printed. TEMS surgical guides were designed and 3D-printed for each surgical site. Three board-certified endodontists used the original CBCT to plan and perform EMS on models of six maxillary and six mandibular teeth. Next, the same endodontists performed TEMS on duplicate 3D-printed models for the same teeth. All surgeries were timed. Postoperative CBCT images of experimental models were made and imported into Amira software for measurement of bevel angle and site volumetric profiles. Paired t-tests compared the mean differences between EMS and TEMS groups. A Bonferroni correction determined data to be significant at P < 0.004. Results TEMS significantly reduced surgical time (P < 0.00001), had bevel angles more closely approaching zero degrees (P < 0.01) and had significantly less volume of over-resection (P < 0.001) and length of root resection (P < 0.01).Conclusions In this surgical simulation scenario, TEMS provided more efficient completion of osteotomy and resection, with a more appropriate root-end resection volume and bevel angle.

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