Feasibility and Clinical Efficacy of Minimally Invasive Straight-Incision Endodontic Microsurgery Guided by 3-Dimensional-Printed Templates: A Retrospective Case Series.

Abstract

Introduction: Endodontic microsurgery (EMS) is a minimally invasive treatment for persistent periapical lesions. This study evaluates the accuracy and outcomes of a straight-incision EMS guided by 3D-printed template, with at least one year of follow-up.

Methods: Twelve teeth from nine patients underwent minimally invasive straight-incision EMS using 3D-printed templates and a trephine for both osteotomy and root-end resection. Clinical outcomes, deviations in resection length and angle, and mucosal incision healing were retrospectively assessed.

Results: Trephine-based root-end resection was successful in all cases, with no intraoperative or postoperative complications. Clinical and radiographic evaluations confirmed success in all patients after one year. Median resection length deviation was 0.79 mm (95% CI: 0.49-1.16), and angular deviation was 19° (95% CI: 8.03-25.47). All cases showed favorable and rapid wound healing, except for case 12.

Conclusions: Straight-incision EMS guided by 3D-printed templates is a precise, minimally invasive, and esthetically favorable technique that enables accurate root-end resection and promotes effective healing.