S-11 - Piezosurgery : New Trends and Keys of Success for a Minimally Invasive Endodontic Microsurgery

Endodontic Microsurgery is often used as the ultimate solution to remove a persistent apical lesion and address the endodontic disease, especially if a conventional retreatment might compromise the prognosis of the tooth.
In the Area of “minimally invasive dentistry” saving the bone while offering a valid exposure of the surgical target and improving bone healing is highly recommended. Thus, the use of piezo and ultrasonic instrumentation should be parts of the responses. It might present considerable advantages such as increasing hemostasis during the surgery and the “quality of life” after.
The “Bony Lid” approach can be a minimally invasive solution. On lower molars, traditional access must be very invasive with a thick mandibular bone and on upper molars the sinus apical projection may make the access more complex, thus with a bony lid the visibility and the access of the lesion for the root preparation and filling would be more predictable. Precise and thin osteotomies for outlining the bony window can be obtained with piezo surgery and facilitates the removal of the bony segment and enables its exact fit at the end of the surgery. Adding PRF or collagen preparations (clots and membranes), will favor a stable re-seating of the lid and allow a better and quicker bone healing.
On Endodontic Microsurgery, Piezo Surgery and particularly the “Bony Lid” technique may allow the operator an easier surgery and a quicker healing with a high regenerative healing potential, especially on molar operative site.