Cone beam computed tomography assisted endodontic surgery of maxillary first molar teeth

Palatal roots of maxillary molar teeth pose special challenge for the surgical approach. Recently, endodontic surgery for posterior teeth, in particular for the palatine root of the maxillary first molar teeth, has been shown to be a substitute for root amputation or extraction.The purpose of this prospective, randomized, controlled clinical study was to evaluate the contribution of CBCT on the surgical procedure of diagnosis and treatment planning on endodontic surgery of palatinal root of maxillary first molar tooth via buccal approach.Forty patients bearing clinical and radiological criteria, which are defined previously, are divided into 2 groups randomly. Patients who underwent examination and presurgical planning by using CBCT were included in Group 1. Patients who underwent examination and presurgical planning by using conventional radiographs were included in Group 2. All surgical procedures were performed by using the buccal approach. The data were statistically analyzed.Sinus membrane elevation was performed in 92.31% of all patients . It is shown that mean operation time in Group 1 was significantly shorter than Group 2 (p = 0.001 <0.05) . Sinus membrane perforation was occurred in 20% of patients in Group 1, and 42.1% of patients in Group 2. According to radiographic and clinical healing criteria, 35% of patients was succeeded, 40% was improved, 25% was failed in Group 1 and 42,1% of patients was succeeded, 31,6% was improved and 26,3% was failed in Group 2.Endodontic surgery of the palatal root of maxillary first molar via buccal approach, is an alternative treatment method to the palatal approach with high complication risk. Further prospective clinical studies with more number of patients, are required for better evaluation of success.