Digitally guided corticotomy using a customized surgical template (Suya corticotomy utility template): A technique report.

Background: Precise control of corticotomy lines is critical in surgically facilitated orthodontic therapy. The Suya method is traditionally performed freehand, which introduces risks of root damage and procedural inconsistency. A digitally guided protocol may address these limitations by enhancing safety and technical predictability.

Methods: A digital workflow based on the Suya method was developed using cone-beam computed tomography (CBCT) and intraoral scanning data to generate a three-dimensional (3D) integrated model of the maxilla. Vertical and apical osteotomy lines were virtually planned between roots and in the apical region. A customized surgical template (Suya corticotomy utility template) was designed using free software and fabricated via 3D printing. Guided corticotomy was performed using a piezoelectric device, followed by controlled chisel application along both vertical and apical cuts.

Results: In a 32-year-old female patient, the digitally guided corticotomy was executed with high accuracy and reproducibility. Piezoelectric cortical incisions followed the preplanned paths without deviation. Chisel application along the guide-defined paths resulted in controlled fracturization. Postoperative CBCT confirmed that all osteotomies were positioned safely between roots, with no evidence of root contact or damage.

Conclusions: This digitally guided Suya method provides a reproducible and biologically sound approach for performing root-sensitive corticotomy with enhanced surgical control. The use of 3D-printed guides tailored to piezoelectric instrumentation may improve safety, accuracy, and standardization of corticotomy procedures in interdisciplinary periodontal care.

Key points: A digitally guided corticotomy protocol based on the Suya method enables root-sensitive osteotomy with improved surgical accuracy and safety. CBCT and IOS integration allows for precise virtual planning of osteotomy lines, which can be transferred intraoperatively using a customized 3D-printed guide (Suya corticotomy utility template). The workflow supports reproducible corticotomy in adult patients with dense cortical bone, minimizing the risk of root damage and surgical variability.

Plain language summary: Orthodontic treatments in adults can take a long time due to slower bone remodeling. To speed this up, surgeons may perform a procedure called corticotomy, where small cuts are made in the bone around the teeth to stimulate faster movement. However, doing this by hand can be tricky and risky, especially near tooth roots and nerves. In this report, we describe a new method that uses digital planning and a custom-made surgical guide (called the Suya corticotomy utility template) to help perform these bone cuts with much more precision. The guide is created by combining three-dimensional (3D) images from dental scans and carefully planning the cutting paths in a computer program. We then 3D-print the guide and use it during surgery to safely direct the surgical instruments. In the case we present, the procedure went smoothly, and post-surgery scans showed no damage to the teeth. This approach may make the procedure safer and more predictable for patients, especially in complex orthodontic cases.