This study compared the accuracy and efficiency of a novel static computer-aided surgical technique using a 3-dimensional (3D)-printed surgical guide (3D-SG) with a fully guided drill protocol (3D-SG FG) to the freehand (FH) osteotomy and root-end resection (RER).
Forty-six roots from 2 cadaver heads were divided into 2 groups: 3D-SG FG (n = 23) and FH (n = 23). Cone-beam computed tomographic scans were taken preoperatively and postoperatively. The endodontic microsurgery was planned in Blue Sky Bio software, and the 3D-SG was designed and 3D printed. The osteotomy and RER were conducted using a guided twist drill diameter of 2 mm and an ascending tapered drill with diameters of 2.8/3.2, 3.2/3.6, 3.8/4.2, and 4.2 mm with respective guided drill guides. Two-dimensional and three-dimensional virtual deviations and angular deflection were calculated. Linear osteotomy measures and root resection angle were obtained. The osteotomy and RER time and the number of mishaps were recorded.
Two-dimensional and three-dimensional accuracy deviations and angular deflection were lower in the 3D-SG FG protocol than in the FH technique (P < .05). The height, length, and depth of the osteotomy and root resection angle were less in the 3D-SG FG protocol than in the FH technique (P < .05). The osteotomy and RER time with the 3D-SG FG protocol were less than the FH method (P < .05).
Within the limitations of this cadaver-based study using denuded maxillary and mandibular jaws, 3D-SG FG protocol showed higher accuracy than FH osteotomy and RER. Moreover, the 3D-SG FG drill protocol significantly reduced the surgical time.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Endodontics
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Modern endodontic surgery concepts and practice: a review.J Endod. 2006; 32: 601-623
- Modern endodontic microsurgery concepts: a clinical update.Dent Clin North Am. 2017; 61: 81-91
- Guided modern endodontic surgery: a novel approach for guided osteotomy and root resection.J Endod. 2017; 43: 496-501
- Targeted endodontic microsurgery: a novel approach to anatomically challenging scenarios using 3-dimensional-printed guides and trephine burs-A report of 3 cases.J Endod. 2018; 44: 671-677
- Computer-aided design/computer-aided manufacturing-guided endodontic surgery: guided osteotomy and apex localization in a mandibular molar with a thick buccal bone plate.J Endod. 2018; 44: 665-670
- Accuracy and clinical safety of guided root end resection with a trephine: a case series.Head Face Med. 2019; 15: 30
- Targeted endodontic microsurgery: computed tomography-based guided stent approach with platelet-rich fibrin graft: a report of 2 cases.J Endod. 2019; 45: 1535-1542
- Targeted endodontic microsurgery: digital workflow options.J Endod. 2020; 46: 863-871
- A new minimally invasive guided endodontic microsurgery by cone beam computed tomography and 3-dimensional printing technology.Restor Dent Endod. 2019; 44: e29
- Targeted endodontic microsurgery and endodontic microsurgery: a surgical simulation comparison.Int Endod J. 2020; 53: 715-722
- A comparative analysis of the piezoelectric ultrasonic appliance and trephine bur for apical location: an in vitro study.J Pers Med. 2021; 11: 1034
- Preserving the neurovascular bundle in targeted endodontic microsurgery: a case aeries.J Endod. 2021; 47: 509-519
- Accuracy and efficiency of guided root-end resection using a dynamic navigation system: a human cadaver study.Int Endod J. 2021; 54: 793-801
- Comparison of the accuracy and efficiency of a 3-dimensional dynamic navigation system for osteotomy and root-end resection performed by novice and experienced endodontists.J Endod. 2022; 48: 1327-1333.e1
- Real-time 3-dimensional dynamic navigation system in endodontic microsurgery: a cadaver study.J Endod. 2022; 48: 922-929
- Nobel Biocare guided surgery tooling.(Available at:)Accessed January 2022)
- The resection angle in apical surgery: a CBCT assessment.Clin Oral Investig. 2016; 20: 2075-2082
- The influence of guided sleeve height, drilling distance, and drilling key length on the accuracy of static computer-assisted implant surgery.Clin Implant Dent Relat Res. 2019; 21: 101-107
- Limitations and management of static-guided endodontics failure.J Endod. 2022; 48: 273-279
- The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis.Clin Oral Implants Res. 2018; 29: 416-435
- Accuracy and complications using computer-designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature.Clin Implant Dent Relat Res. 2012; 14: 321-335
- Guided surgery: accuracy and efficacy.Periodontol 2000. 2014; 66: 228-246
- Accuracy of a computerized tomography-guided template-assisted implant placement system: an in vitro study.Clin Oral Implants Res. 2009; 20: 1156-1162
- Technical accuracy of printed surgical templates for guided implant surgery with the coDiagnostiX software.Clin Implant Dent Relat Res. 2015; 17: e177-e182
- The influence of the tolerance between mechanical components on the accuracy of implants inserted with a stereolithographic surgical guide: a retrospective clinical study.Clin Implant Dent Relat Res. 2015; 17: 580-588
- Tolerance within the sleeve inserts of different surgical guides for guided implant surgery.Clin Oral Implants Res. 2013; 24: 630-634
- Registration of cone beam computed tomography data and intraoral surface scans–a prerequisite for guided implant surgery with CAD/CAM drilling guides.Clin Oral Implants Res. 2017; 28: 1113-1118
- Virtual bite registration using intraoral digital scanning, CT and CBCT: in vitro evaluation of a new method and its implication for orthognathic surgery.J Craniomaxillofac Surg. 2016; 44: 1194-1200
- Perforation of the maxillary sinus floor during apical surgery of maxillary molars: a retrospective analysis using cone beam computed tomography.Aust Endod J. 2020; 46: 176-183
- Assessment of technical skills transfer from the bench training model to the human model.Am J Surg. 1999; 177: 167-170
Published online: February 21, 2023
Publication stageIn Press Corrected Proof
© 2023 American Association of Endodontists.