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Abstract

Objective: This case report describes the treatment of the maxillary central incisor with open apex and symptomatic apical periodontitis by orthograde mineral trioxide aggregate (MTA) apical plug placement and endodontic microsurgery, facilitated by the integrated use of a dynamic navigation system and a piezoelectric device.

Methods: An 18-year-old female presented to the Department of Conservative Dentistry and Endodontics, Vishnu Dental College, with the chief complaint of pain on biting in the upper anterior region. Clinical examination showed tenderness on percussion and palpation in relation to tooth #11. Radiographic and cone-beam computed tomography (CBCT) evaluation demonstrated an open apex associated with a periapical lesion. Based on these findings, a diagnosis of previously initiated therapy with symptomatic apical periodontitis was established. An apical plug was placed using MTA, followed by apicectomy performed with a piezoelectric device under the guidance ofa dynamic navigation system

Results: Postoperative healing was uneventful, and at the 14-month follow-up, the tooth remained asymptomatic, with radiographic and CBCT evidence of periapical bone regeneration.

Conclusion: The integration of dynamic navigation and piezoelectric osteotomy appeared to be a safe and predictable technique in endodontic microsurgery, supporting precision, conservation, and favorable healing.

Pages

74

DOI

10.65844/2503-0825.1484

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