title: Guided Modern Endodontic Surgery: A Novel Approach for Guided Osteotomy and Root Resection.
abstract: BACKGROUND
  Continuous improvements in techniques, instruments, and materials have established modern endodontic microsurgery as a state-of-the-art treatment method. The purpose of this approach was to introduce a new surgical endodontic technique by using a three-dimensional printed template for guided osteotomy and root resection.
  
  
  METHODS
  A 38-year-old patient was diagnosed with periapical lesions of teeth #3 and #4 and extruded gutta-percha material. Three-dimensional radiographic and optical scan files were imported into surgical planning software designed for guided implant surgery. Within the adapted software program the periapical lesions and the extruded gutta-percha were visualized and marked. With the aid of virtually positioned surgical pins and piezoelectric instruments, the osteotomy size, the apical resection level, and the bevel angle were defined before treatment. Three-dimensional surgical templates for each tooth were designed within the software program for a guided treatment approach.
  
  
  RESULTS
  This approach comprised the treatment of periapical lesions of teeth #3 and #4 with root-end fillings and the detection and complete removal of the extruded gutta-percha material without perforation of sinus membrane. There were no postoperative complications, and clinical and radiologic assessments verified complete healing of the teeth.
  
  
  CONCLUSIONS
  The guided microsurgical endodontic treatment presented appears to be a viable technique that allows for predefined osteotomies and root resections.
authors.affiliation: Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria. Electronic address: georg.strbac@meduniwien.ac.at.
authors.forename: Georg D
authors.initials: GD
authors.lastname: Strbac
authors.affiliation: Software Research, Dental Wings, Chemnitz, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Schnappauf
authors.affiliation: Unit - Division of Dental Student Training and Patient Care, School of Dentistry, Medical University of Vienna, Vienna, Austria.
authors.forename: Katharina
authors.initials: K
authors.lastname: Giannis
authors.affiliation: Conservative Dentistry and Periodontology, Unit - Division of Dental Student Training and Patient Care, School of Dentistry, Medical University of Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Moritz
authors.affiliation: Division of Oral Surgery, School of Dentistry, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Ulm
mesh_terms: D000328:Adult; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging / Q000601:surgery; D004708:Endodontics / Q000379:methods; D005260:Female; D006801:Humans; D008866:Microsurgery / Q000379:methods*; D003765:Models, Dental; D010027:Osteotomy / Q000379:methods*; D010483:Periapical Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D066330:Printing, Three-Dimensional; D011861:Radiography, Dental; D012390:Root Canal Therapy / Q000379:methods*; D012984:Software
keywords: 3D printed template; Guided endodontic surgery; guided osteotomy; guided root resection; modern endodontic microsurgery; surgical template