(TC14) Expose the ‘Root’ of Your Problems: Cutting-Edge Choices in Osteotomy Techniques

Apicoectomy is a pivotal endodontic surgery involving root-end resection to address persistent periapical infections. A component to its success is the osteotomy technique employed, as it impacts precision, healing, and postoperative outcomes. This table clinic demonstrates, evaluates, and compares three osteotomy methods: the use of the conventional bur, Piezoelectric surgery, and laser ablation with an Er, Cr:YSGG laser. The conventional technique using a carbide bur excels in bone removal efficiency but may induce heat and mechanical stress that compromise surrounding tissue integrity. Alternatively, piezoelectric surgery utilizes ultrasonic vibrations, providing a controlled, bone-selective approach creating a boney window that minimizes trauma and improves patient tolerance – although it may take more time. Recent advancements in laser techniques allow for targeted, minimally invasive access with enhanced precision and reduced postoperative discomfort, though thermal effects on tissue remain a consideration. This table clinic presents a side-by-side comparison of these techniques, highlighting practical insights into their clinical applications, patient outcomes, and potential complications. By offering an evidence-based exploration of each technique’s benefits and limitations, this table clinic supports informed surgical decision-making, ultimately aiming to optimize patient care in endodontics.