Periapical Microsurgery: A 4-dimensional Analysis of Healing Patterns.

Abstract:

INTRODUCTION:Currently, the success of periapical microsurgery is determined by the restoration of the lamina dura and the elimination of symptoms. However, inadequate site preservation may prevent later implant placement. Although not possible before, the advent of cone-beam computed tomographic imaging and computer-aided registration allows for indirect and accurate 3-dimensional analysis of the surgical site over time. This study analyzed the volumetric healing pattern of the buccal plate after periapical microsurgery, with a specific focus on the buccolingual thickness of bone and the regression of the surface contour of the cortical plate. METHODS:Thirty-seven patients were scheduled for follow-up at least 1 year after periapical microsurgery (median = 25 months, total range = 12-31 months). Volumetric healing was analyzed by converting preoperative and postoperative cone-beam computed tomographic images into digital 3-dimensional models. The models were then registered to be able to analyze the changes in volume over time. Analysis was completed using Geomagic software (3D Systems, Rock Hill, SC), which allowed for registration of the volumes, calculation of volume change, and calculation of the margin of error. RESULTS:Twelve cases qualified for volumetric analysis. The median volumetric reduction of the cortical plate was -24.9 mm3 (interquartile range = -8.94 to -67 mm3), with an average linear error of 0.7 mm. This corresponded to an average loss in buccolingual dimension of 0.1-0.25 mm. Regression of the cortical plate was within the margin of error in all cases. CONCLUSIONS:After periapical microsurgery, and in the absence of grafting materials or membranes, healing occurs with little to no regression of the buccal cortical plate.

journal_name

J Endod

journal_title

Journal of endodontics

authors

Crossen D,Morelli T,Tyndall DA,Tawil PZ

doi

10.1016/j.joen.2018.11.002

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

402-405

issue

4

eissn

0099-2399

issn

1878-3554

pii

S0099-2399(18)30755-6

journal_volume

45

pub_type

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