Piezoelectric Endodontic Microsurgery with Modified Cortical Window Technique: A Case Report

Abstract

Osteotomy in endodontic microsurgery for teeth with periapical lesions which have not perforated the cortical plate can be a complex procedure especially if anatomical structures such as the mental nerve are close to the area of ​​surgical intervention. For such cases, the cortical bone window technique is an excellent option to access the operating field, preserving the cortical bone and avoiding the use of other bone regeneration materials. The present case documented the use of the cortical bone window technique with a modification, due to the proximity of the mental nerve to approach a persistent periapical lesion of a mandibular second premolar with previous endodontic treatment. Cone beam tomography (CBCT) and intraoral scanning were used for planning and elaboration of a navigation guide for surgical procedure. The clinical and radiographic 5-month follow-up with periapical radiography and CBCT revealed a favorable outcome, with an asymptomatic patient and an advanced healing process at the previous periapical lesion site.