Li Xiaoxing, Huang Lishan, Li Siyu, Lao Siying, Yan Ningxin, Wu Haitong, Yang Xuechao
Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, 510182, China.
Department of Endodontics, School and Hospital of Stomatology, Guangdong Engineering Research Center of Oral Restoration and Reconstruction & Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Guangzhou Medical University, Guangzhou, 510182, China.
J Endod. 2024 Dec;50(12):1777-1783. doi: 10.1016/j.joen.2024.10.001. Epub 2024 Oct 9.
Endodontic microsurgery (EMS) is an alternative treatment option for previously treated teeth with persistent periapical disease, offering a favorable prognosis. However, it can be particularly challenging in anatomically complex cases, risking unintentional damage to adjacent critical structures. Dynamic navigation (DN), a computer-aided technique, facilitates precise presurgical planning and provides real-time guidance during operation. Integrating the DN technique into EMS procedures can enhance treatment accuracy and effectiveness. This report presents 4 cases involving a minimally invasive incision approach for DN-aided EMS in anatomically complex regions, all of which were completed without complications. After 3-12 months, patients presented asymptomatic, and radiographic examinations revealed complete healing or the periapical radiolucent area decreased in size. The DN technique contributed to reliably mitigating the risk of iatrogenic damage in complicated EMS scenarios. The minimally invasive incision approach not only provided sufficient visibility but also promoted favorable soft tissue healing, making it a valuable addition to surgical endodontics.
牙髓显微外科手术（EMS）是治疗先前治疗过但仍患有持续性根尖周病牙齿的一种替代治疗选择，预后良好。然而，在解剖结构复杂的病例中，该手术极具挑战性，存在意外损伤相邻关键结构的风险。动态导航（DN）作为一种计算机辅助技术，有助于精确的术前规划，并在手术过程中提供实时引导。将DN技术整合到EMS手术中可提高治疗的准确性和有效性。本报告介绍了4例在解剖结构复杂区域采用微创切口进行DN辅助EMS的病例，所有病例均顺利完成，无并发症发生。3至12个月后，患者无症状，影像学检查显示完全愈合或根尖周透射区缩小。DN技术有助于可靠地降低复杂EMS手术中发生医源性损伤的风险。微创切口方法不仅提供了足够的视野，还促进了软组织的良好愈合，使其成为牙髓外科手术的一项有价值的补充。
