Guided Endodontic Micro-Surgery (GEMS): A Novel Approach for a Targeted Apicoectomy—A Report of 3 Cases

Abstract

AbstractGuided endodontic microsurgery, also known as guided endodontic microsurgery, is a surgical procedure used to treat failed endodontically treated teeth with periapical infections. Guided endodontic microsurgery can be problematic in some situations, such as when there are tough anatomical features or limited surgical access. Some of these complex cases can be managed using cone beam computed tomography imaging, CAD software design, and 3D printing technologies. A surgical stent was manufactured using a 3D printer in each of the three cases. Prior to surgery, the infection location, depth, and angulation of preparation were determined to protect sensitive anatomical components. The target location is chosen to ensure precise root excision and avoid infection during surgery. Infected root tip resection and biopsy were accomplished in one step by rotating a trephine bur in the surgical stent hole. Once the root preparation and the retrograde filling were completed, bone graft material can be added to the surgical site and then the tissues were sutured to achieve primary closure. Surgical stents produce effective targeted apicoectomy with a certain angle and depth of preparation. In addition, the soft tissue is reflected or protected with the unique features of the stent.