Additive manufacturing and digital design assisted precise apicoectomy: a case study

Purpose - The purpose is to realize precise apicoectomy with less surgical risk and improved quality and efficiency. Design/methodology/approach - First, the procedure of precise apicoectomy based on additive manufacturing (AM) and digital design is proposed. With CT images of the patient's oral, a 3D model of alveolar bone and teeth is reconstructed, and based on this model, the infected tissue and enclosed root tip can be determined. Thus, a surgical plan can be created based on clear anatomical relationships and minimal negative constraints, which will then determine the drill position, direction and depth, as well as the resection length of root tip. With this plan, a surgical guide design is performed via a composite model from reversed plaster models and hard tissue models from CT, and accessory tools including drill with stop plane and handle are also selected. With the surgical guide, the virtual plan in the computer can be realized in the clinic. Findings - With this methodology, the dentist can perform root-end resection with greater accuracy, save more than 30 percent of operatory time, and the discomfort to the patient is reduced to a minimum. Practical implications - The proposed methodology has been used in ten cases for root-end resections. In fact, this method of designing a computerbased treatment plan with a 3D model of a patient and applying it in the clinic through guiding tools can be used in other surgeries, such as orthognathic surgery or osteotomy. Originality/value - This case report illustrates that with AM and digital design methods, optimal operational plans can be designed and realized for apicoectomy, and the quality and efficiency of clinical surgery are greatly improved compared with conventional methods.