Targeted Endodontic Microsurgery: A Retrospective Outcomes Assessment

Abstract

Introduction: Targeted Endodontic Microsurgery (TEMS) replaces freehand carbide or diamond bur osteotomy and root end resection with a guided approach using an end-cutting trephine bur rotated within a guide tube. TEMS departs from traditional EMS in osteotomy size, control of resection level and bevel, surgical time and resection method, yet the impact of these departures upon clinical outcomes has yet to be assessed. The aim of this study is to assess clinical outcomes of TEMS surgeries at least one year after treatment. Methods: Potential cases were retrospectively identified from a secure database of all patients that received TEMS in the Air Force Postgraduate Dental School from June 2017 to May 2019 with a postsurgical recall exam at 1 year or beyond (23 patients with 24 teeth). Two board certified endodontists completed a calibration exercise prior to assessing radiographs. A retrospective outcomes assessment was conducted considering recall clinical and radiographic findings to assign one of three healing designations: complete healing, reductive healing, or failure. Results: Combined clinical and radiographic data led to 20 designations of complete healing, 2 designations of reductive healing and 2 failures (91.7% success rate). Considered alone, radiographic criteria for complete healing were met for 20 cases, reductive healing by 3 cases with 1 radiographic failure. Conclusions: This limited retrospective outcomes assessment is an early indication that TEMS guided trephine bur root end resection leads to similar success as is established for freehand carbide and diamond bur resection. Controlled clinical trials with long-term follow-up are warranted.

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Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2020
Accession Number
AD1111374

Entities

People

  • Allen M. Pratt
  • Arianne Buniag
  • Jarom J. Ray

Organizations

  • 59th Medical Wing

Tags

DTIC Thesaurus Topics

  • Agreements
  • Air Force
  • Biocompatible Materials
  • Calibration
  • Clinical Trials
  • Databases
  • Department Of Defense
  • Materials
  • Medical Personnel
  • Microsurgery
  • Signs And Symptoms
  • Statistical Analysis
  • Surgery
  • Teeth
  • Three Dimensional
  • United States
  • X-Ray Computed Tomography

Fields of Study

  • Medicine

Readers

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