BDJ Open · Published 2026-07-14 · DOI 10.1038/s41405-026-00461-w
Rami Kaddoura, Thuraya Lazkani, Yasser Alsayed Tolibah
Abstract Aim This randomized controlled clinical trial evaluated the effectiveness of guided endodontic microsurgery (GEMS) compared to conventional endodontic microsurgery (EMS) in critical anatomy regions. Materials and methods Twenty-eight patients (ages 19–58 years) requiring endodontic microsurgery in critical anatomical regions were randomly allocated to guided surgery (n = 14) using 3D-printed surgical guides with trephine burs or conventional microsurgery (n = 14). Primary outcomes included surgical procedure time. Secondary outcomes were periapical lesion size measured by CBCT at 6, 12 months and success rate at 1-year follow-up and complications. statistical analysis employed independent t-tests and chi-square tests. Results The guided group demonstrated significantly shorter surgical time (18.21 ± 3.45 min vs 26.07 ± 4.29 min) (independent t-test, p < 0.001). Complete lesion resolution at 1 year was achieved in 92.9% of guided cases, compared with 71.4% in conventional cases (chi-square, p = 0.139). No complications were observed. Conclusions Guided endodontic microsurgery using a 3D-printed surgical guide with trephine burs significantly reduces surgical time. The technique demonstrates a clinically relevant trend toward improved healing outcomes, supporting its adoption for complex endodontic surgical cases. Trial registration ClinicalTrials.gov Identifier: NCT05283252
Abstract from DOAJ. Public domain (CC0 1.0).
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Kaddoura, R., Lazkani, T., Tolibah, Y. (2026). Effectiveness of guided endodontic microsurgery using a trephine bur in critical anatomical regions: a randomized controlled clinical trial. BDJ Open. https://doi.org/10.1038/s41405-026-00461-w