Guided endodontic microsurgery using a simplified surgical guide for mandibular first molars with intact buccal cortical bone

다국어 초록 (Multilingual Abstract)

Endodontic microsurgery in mandibular molars is often challenging because of limited surgical access and the presence of thick buccal cortical bone. This case report presents two cases in which a simplified digital surgical guide was used to facilitate precise osteotomy and localization of the root apex in mandibular molars with intact buccal cortical bone. Both patients presented with symptomatic apical periodontitis associated with previously treated mandibular first molars. Radiographic and cone-beam computed tomography (CBCT) examinations identified periapical lesions involving the mesial roots, with intact buccal cortical plate. A surgical guide was digitally designed by integrating intraoral scan data with CBCT images using implant planning software and was fabricated via 3D printing. The guide enabled accurate determination of the initial osteotomy position. Guided osteotomy allowed precise localization of the root apex with minimal bone removal, and both cases demonstrated favorable clinical and radiographic healing during follow-up.