OR14 - A Comparison of Radicular Microfractures After Apical Root Resection Using Either a Fissure Bur or a Piezoelectric Tip

Abstract: Endodontic microsurgery aims to resolve persistent apical periodontitis when conventional root canal treatment has failed. Piezoelectric instrumentation is particularly useful in endodontic surgery due to its ability to selectively cut mineralized tissue while minimizing damage to surrounding soft tissue. However, no studies have specifically evaluated whether piezoelectric root-end resection may generate dentinal cracks. This study aimed to compare the incidence of radicular microfractures following root-end resection with a fissure bur versus a piezoelectric tip. Thirty-three matched pairs of roots from seven human cadaver mandibles were used. Each root underwent root-end resection with either a Lindemann bur or a piezoelectric tip. Following resection, the root ends were stained with India Ink. Using a surgical operating microscope and transillumination, two blinded evaluators scored the roots according to the presence and extent of dentin microfractures. A score of 1 was assigned to roots with no microfractures, a score of 2 to roots with microfractures that originated from the root surface or canal wall but did not traverse the root entirely, and a score of 3 to roots with microfractures that extended from the root surface to the canal wall. Sixty-two roots showed no microfractures (score 1), while four roots exhibited dentin microfractures (one with a score of 2 and three with a score of 3). Pearson's chi-squared revealed no significant difference between the two groups (p > .05).There was no significant difference in radicular microfractures after root-end resection using either a Lindemann bur or a piezoelectric tip.