Predictable success in endodontic microsurgery – CBCT 3D visualisation and high-power magnification

Over the past decades the use of the surgical microscope has become a routine procedure for endodontic specialists.

Furthermore ultrasonic tips, microinstruments as well as biocompatible root-end filling materials have significantly improved the technical approach. Endodontic surgery has evolved into endodontic microsurgery, providing high success rates. However, from a clinical point of view molar surgery remains a challenge. Surgery in molars is associated with technical difficulties such as the close proximity of the apices or pathologic process to the mandibular canal or sinus maxillaris, difficult access to the root tips as a result of the posterior location and thickness of the buccal cortical bone plate.

The introduction of cone-beam computed tomography (CBCT) and threedimensional visualization of the anatomy represented an important new development in dentomaxillofacial radiology, not only overcoming the difficulties in diagnosis and treatment planning of the microsurgical procedure but also in assessment of long term success.