(TC55) Freeman's Interocclusal Surgical Helper (FISH): A Novel Technique to Enhance Stability During Apical Surgery

Achieving optimal access, visibility, and isolation during apicoectomy procedures is critical for successful outcomes. However, maintaining a controlled mouth opening can be challenging due to patient discomfort and involuntary jaw movement, particularly under magnified visualization. Saliva contamination from the patient’s tongue movement is another difficulty during the procedure. This presentation introduces Freeman's Interocclusal Surgical Helper (FISH), a novel technique designed to address these challenges.
The FISH technique employs injectable elastomeric bite registration material, polyvinyl siloxane (PVS), to create a customized interocclusal bite block. Following local anesthesia administration, the PVS material is mixed and injected onto the occlusal surfaces of the patient's full arch. The patient is instructed to bite down into the desired position for a duration of two minutes, allowing the material to set. Excess material is trimmed to avoid obstructing the surgical field, and the bite block is reinserted to confirm proper seating.
Preliminary observations indicate that the use of the FISH technique significantly reduces jaw fatigue and involuntary movement during procedures. Enhanced stability allows for improved focus on the surgical site, contributing to a more efficient workflow and potentially better clinical outcomes. The PVS material that flows into the interproximal surface can also block the saliva from entering the surgical site while the patient’s tongue is moving, hence achieving better isolation during the procedure. Further studies are warranted to evaluate its effectiveness in diverse clinical settings.
Keywords: apicoectomy, surgical technique, interocclusal record, bite block, endodontics