(TC55) Surgical Decompression: Not Just a Prelude to Endodontic Microsurgery

The purpose of this presentation is to introduce the use and clinical effectiveness of a novel 3D printed surgical decompression device (SDD) to induce healing of a large periapical lesion. The purpose of the treatment is to reduce the size of the lesion and prevent the need for more invasive endodontic surgery, especially when the lesion is close to vital structures. There have been a multitude of materials/items used to accomplish decompression of large periapical lesions, which are often difficult to suture in place or to maintain a patent opening into the lesion. This results in poor patient compliance and outcomes of decompression. The CAD design of our SDD devices overcomes many of these challenges. We will use clinical case examples to show how modern digital technology in the form of CBCT, CAD design, and 3D printing has allowed us to reduce the size of large periapical lesions/cyst in a short period of time. The novel device was well-tolerated, and a patent lumen allowed the patient to flush out the lesion daily with ease. We have noted large lesions showing significant radiographic signs of healing with bony infill and periodontal ligament formation while resolving intra-oral swelling and pain. Well designed, customized surgical decompression devices can promote good patient compliance and rapid periapical healing that could prevent the need for invasive endodontic microsurgery.