Targeted Endodontic Microsurgery: A Retrospective Outcomes Assessment of 24 Cases.

Abstract

INTRODUCTION\nTargeted 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 endodontic microsurgery (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.\n\n\nMETHODS\nPotential 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 follow-up 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 follow-up clinical and radiographic findings to assign one of three healing designations: complete healing, reductive healing, or failure.\n\n\nRESULTS\nCombined 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.\n\n\nCONCLUSIONS\nThis 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.