(TC56) Heat Generation and Microfractures Utilizing the Piezoelectric Ultrasonic Versus High-speed Carbide Burs in Microsurgical Root-end Resections

Root-end resection is indicated when root-filled teeth present with periapical pathosis that is unlikely to resolve with conventional orthograde treatment options. The goal of root-end resection is to remove residual microorganisms at the root end as well as extraradicular biofilm and create a proper apical seal. Modern endodontic surgery involves the use of magnification with the surgical operating microscope, improved root-end fill materials, CBCT imaging, and instruments. Currently, there are many techniques used during root-end resection. One technique is the use of the Piezoelectric Ultrasonic. 

Several advantages of using the Piezoelectric Ultrasonic include that it is selective cutting, allows for optimal visualization of the surgical field, and can contribute to hemorrhage control. Disadvantages include the need for adequate irrigation to prevent overheating and bone necrosis, the financial burden of the initial purchase, and longer duration of the surgical procedure.

While the success rate of endodontic surgery has improved, there are several factors to consider for a favorable surgical outcome, such as heat generation and the development of microfractures. The purpose of this table clinic is to demonstrate the use of Piezoelectric Ultrasonic in root-end resection and illustrate the amount of heat and microfracture generation compared to traditional bur resection. This knowledge can help clinicians be aware of the magnitude of heat generation and potential microfractures created with both techniques.