Assessment of guided versus non-guided endodontic microsurgery with root-end resection using different retrograde filling materials on operation time and lesion volume: A randomized controlled clinical study.

[BACKGROUND] Guided microsurgery has been proposed to improve precision and reduce operation time, but its effect on bone healing remains unclear.

[AIM] To compare guided microsurgical root end resection and different retrograde filling materials versus non-guided endodontic microsurgery on operation time and lesion bone volume using cone-beam computed tomography (CBCT).

[SUBJECTS AND METHODS] 24 patients undergoing apicoectomy for anterior maxillary teeth were selected according to inclusion and exclusion criteria. Then they were randomly divided into two groups: Group A, receiving endodontic microsurgery without a surgical guide ( = 12), and Group B, utilizing a surgical guide ( = 12). Each of these groups was further subdivided into two smaller groups of six, based on the retrograde filling material used: Subgroup S1 for mineral trioxide aggregate (MTA)-Angelus and Subgroup S2 for Well-Root Putty. Operation time was recorded intraoperatively. Lesion volume was assessed using CBCT scans taken 1 week and 6 months after surgery. Data were analyzed statistically to evaluate differences among the groups.

[RESULTS] The guided group showed a significantly shorter operation time (26-27.5 min) compared with the non-guided group (39-47 min), with no significant difference between retrograde filling materials. All groups exhibited a significant reduction in lesion volume at 6 months, with no significant intergroup differences.

[CONCLUSION] guided microsurgery effectively reduced surgical time but had no impact on bone lesion volume. MTA-Angelus and Well-Root Putty showed comparable clinical performance.