3D Apicoectomy Guidance: Optimizing Access for Apicoectomies

Limitations and Management of Static-guided Endodontics Failure

“…In some circumstances, the calcification process is so severe that this may not be easily detectable. In those cases, the operator must avoid inserting the instrument beyond the limits of the 3D planning, and other strategies must be conducted to improve root canal disinfection (24,27,28). Apical surgery should be considered the treatment of choice in the cases of PCO in which a straight line to the patent canal cannot be achieved by the bur with guided endodontics in severely curved canals in order to remove unreachable infected areas and seal the root canal (27,28).…”

“…In those cases, the operator must avoid inserting the instrument beyond the limits of the 3D planning, and other strategies must be conducted to improve root canal disinfection (24,27,28). Apical surgery should be considered the treatment of choice in the cases of PCO in which a straight line to the patent canal cannot be achieved by the bur with guided endodontics in severely curved canals in order to remove unreachable infected areas and seal the root canal (27,28). Over the last 20 years, modern endodontic microsurgery have improved the prognosis of complex cases and iatrogenic root perforation (29).…”

Guided Endodontics: A Literature Review

“…Eighteen of them were performed with only single-rooted teeth [ 3 , 9 , 38 , 40 , 44 , 46 , 50 , 51 , 52 , 53 , 55 , 58 , 60 , 61 , 62 , 63 , 64 , 65 ]. In twenty-five of them, GE was used for the treatment of pulp obliteration [ 3 , 9 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 58 , 60 , 63 , 64 , 65 ], eight for osteotomy and apicoectomy [ 57 , 59 , 61 , 66 , 67 , 68 , 69 , 70 ], two for re-treatment or removal of fiberglass posts [ 43 , …”

“…Osteotomy and apicectomy . Apicoectomy and osteotomy were the second most common treatment performed with GE [ 57 , 59 , 61 , 66 , 67 , 68 , 69 , 70 ]. A retrospective study by Galino Buniag A et al [ 78 ] is the only one that presents the follow-up of patients who underwent SGE treatment after at least 1 year, showing that it is as valid a treatment option as the conventional one (performing a full-thickness flap and using drills and reamers).…”

In vivo and in vitro examination of the efficacy of targeted endodontic microsurgery

“…Tavares and colleagues point out that there are cases when apicoectomy is best performed with intentional misalignment, to preserve neighboring anatomical structures [53]. The conventional drill-based approach with a surgical guide is obviously more favorable in such cases.…”