Abstract:

Objective To investigate the precise positioning role of digital surgical guides in microsurgical apicoectomy for refractory periapical periodontitis and their impact on postoperative healing. Methods Thirty patients diagnosed with refractory periapical periodontitis who had failed conventional root canal treatment were enrolled and randomly divided into an experimental group (digital surgical guides assisted microsurgical apicoectomy) and a control group (traditional freehand microsurgery). Cone-beam computed tomography (CBCT) was performed before and after surgery to compare and analyze surgical accuracy. The surgical time, accuracy of root-end resection, and postoperative pain were compared between the two groups. Results The surgical time in the experimental group (24.05±0.92) min was significantly shorter than that in the control group (32.10±0.80) min. In terms of root-end resection accuracy, the experimental group showed more ideal root-end resection length and angle compared to the control group, with statistically significant differences(P<0.001). No significant complications occurred in any of the thirty patients. The control group exhibited more pronounced pain symptoms on the first, third, and seventh days postoperatively, with statistically significant differences between the two groups on the first and third days(P<0.01). Conclusion Digital surgical guides can enhance the precision of surgery for refractory periapical periodontitis, reduce surgical time, and alleviate postoperative pain.

Key words: digital surgical guides, refractory periapical periodontitis, microsurgical apicoectomy