Aim: The aim of the present pilot study was to assess the preoperative cone-beam computed tomography (CBCT) images with prefabricated grids to locate the periapical pathosis in mandibular molars.
Materials and methods: Two adult human cadavers in which mandibular first permanent molars were selected for this study were selected for this study. A stainless-steel grid has been precisely created. To support the grid, it was positioned along the long axis of teeth on the lingual side by using putty material. In both mandibles, Grid-based CBCT planning was used for the experimental group, while nonguided CBCT planning was used for contralateral counterparts in the same jaw. Postoperatively, CBCT image was superimposed on the preplanned drill path and imported to the DICOM file.
Result: Average osteotomy sites for both the mandibles in experimental groups were 1.75 and 3.25 mm for the control group.
Conclusion: The grid-guided approach for apical access is more precise than the conventional technique. This study proved that the grid is a more conservative and effective aid in endodontic microsurgery.
Kim S, Kratchman S. Modern endodontic surgery concepts and practice: a review. J Endod 2006;32(7):601–623. DOI: 10.1016/j.joen.2005.12.010.
Kim E, Song JS, Jung IY, et al. Prospective clinical study evaluating endodontic microsurgery outcomes for cases with lesions of endodontic origin compared with cases with lesions of combined periodontal-endodontic origin. J Endod 2008;34(5):546–551. DOI: 10.1016/j.joen.2008.01.023.
Kim S. Principles of endodontic microsurgery. Dent Clin North Am 1997;41(3):481–497. PMID: 9248686.
Kim JE, Shim JS, Shin Y. A new minimally invasive guided endodontic microsurgery by cone-beam computed tomography and 3-dimensional printing technology. Restor Dent Endod 2019;44(3):e29. DOI: 10.5395/rde.2019.44.e29.
Tyndall DA, Rathore S. Cone-beam CT diagnostic applications: caries, periodontal bone assessment, and endodontic applications. Dent Clin North Am 2008;52(4):825–841. DOI: 10.1016/j.cden.2008.05.002.
Bergenholtz G, Lekholm U, Milthon R, et al. Retreatment of endodontic fillings. Scand J Dent Res 1979;87(3):217–224. DOI: 10.1111/j.1600-0722.1979.tb00675.x.
Gorni FG, Gagliani MM. The outcome of endodontic retreatment: a 2-yr follow-up. J Endod 2004;30(1):1–4. DOI: 10.1097/00004770-200401000-00001.
Carr GB. Surgical endodontics. In: Cohen S, Burns R, editors. Pathways of the pulp. 6th ed. St Louis: Mosby; 1994. p. 531.
Rubinstein RA, Kim S. Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and super-EBA as root-end filling material. J Endod 1999;25(1):43–48. DOI: 10.1016/S0099-2399(99)80398-7.
Strbac GD, Schnappauf A, Giannis K, et al. Guided modern endodontic surgery: a novel approach for guided osteotomy and root resection. J Endod 2017;43(3):496–501. DOI: 10.1016/j.joen.2016.11.001.
Von Arx T, Hänni S, Jensen SS. Correlation of bone defect dimensions with healing outcome one year after apical surgery. J Endod 2007;33(9):1044–1048. DOI: 10.1016/j.joen.2007.06.010.
Gutmann JL, Harrison JW. Periradicular curettage, root-end resection, root-end filling. In: Guttmann JL, Harrison JW, editors. Surgical endodontics. Boston: Blackwell Scientific Publications; 1991. p. 208–213.
Kim S. Endodontic microsurgery. In: Cohen S, Burns R, editors. Pathways of the pulp. 8th ed. St Louis: Mosby; 2002. p. 683–721.
Kim S, Pecora G, Rubinstein R. Comparison of traditional and microsurgery in endodontics. In: Kim S, Pecora G, Rubinstein R, editors. Color atlas of microsurgery in endodontics. Philadelphia: W.B. Saunders; 2001. p. 5–11.
Wesson CM, Gale TM. Molar apicectomy with amalgam root-end filling: results of a prospective study in two district general hospitals. Br Dent J 2003;195(12):707–714. DOI: 10.1038/sj.bdj.4810834.
Larheim TA, Eggen S. Determination of tooth length with a standardized paralleling technique and calibrated radiographic measuring film. Oral Surg Oral Med Oral Pathol 1979;48(4):374–378. DOI: 10.1016/0030-4220(79)90038-0.
Everett FG, Fixott HC. The incorporated millimeter grid in oral roentgenography. Quintessence Int 1975;6(5):53–58. PMID: 1059181.
Rambabu T, Srikanth V, Sajjan GS, et al. Comparison of tentative radiographic working length with and without grid versus electronic apex locator. Contemp Clin Dent 2018;9(1):88–91. DOI: 10.4103/ccd.ccd_790_17.
Maurya RK, Gupta A, Garg J, et al. A custom made grid to guide placement of temporary anchorage devices 2015 APOS Trends in Orthodontics 5(6):299. DOI: 10.4103/2321-1407.170020.