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Peer-reviewedCC BYFrontiers in surgery

Personalized 3D-printed osteotomy guide combined with an ultrasonic bone scalpel for precise periapical cystectomy: a case report.

  • Jieying Li1,2
  • Haoyu Sun2,3
  • Xiaoyang Shan2,3
  • Zhimin Zhang2,3
  • Huibin Sun2,3
  • Kai Zhou1,2
  1. 1Department of Oral & Maxillofacial Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
  2. 2School of Stomatology, Qingdao University, Qingdao, Shandong, China.
  3. 3Department of Stomatology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
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Abstract

Periapical lesions persisting after root canal treatment, particularly those radiographically suggestive of true cysts, often necessitate surgical management. This report introduces a synergistic technique for precise periapical surgery in anatomically challenging areas, combining a 3D-printed osteotomy guide with an ultrasonic bone scalpel. A personalized, tooth-supported osteotomy guide was designed based on fused cone-beam computed tomography (CBCT) and intraoral scan data to ensure accurate localization of the lesion and minimal buccal bone window dimensions. An ultrasonic bone scalpel was then employed to execute the planned osteotomy, facilitating the reflection of a buccal bone lid that remained attached to the mucoperiosteal flap. Following complete cyst enucleation and apical resection, retrograde root canal filling was performed under microscopic vision. The pedicled bone lid was subsequently repositioned to promote healing and prevent soft tissue ingrowth. This combined protocol effectively addresses the challenges of limited visibility and access in the posterior maxilla, demonstrating a precise and minimally invasive approach for managing complex periapical lesions.

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Cite

BibTeXRIS
BibTeX
@article{li2026personalized,
  title = {{Personalized 3D-printed osteotomy guide combined with an ultrasonic bone scalpel for precise periapical cystectomy: a case report.}},
  author = {Jieying Li and Haoyu Sun and Xiaoyang Shan and Zhimin Zhang and Huibin Sun and Kai Zhou},
  journal = {Frontiers in surgery},
  year = {2026},
  month = oct,
  doi = {10.3389/fsurg.2026.1853640},
  url = {https://europepmc.org/article/MED/42898411},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Personalized 3D-printed osteotomy guide combined with an ultrasonic bone scalpel for precise periapical cystectomy: a case report.
AU  - Jieying Li
AU  - Haoyu Sun
AU  - Xiaoyang Shan
AU  - Zhimin Zhang
AU  - Huibin Sun
AU  - Kai Zhou
PY  - 2026
DA  - 2026/10/05
JO  - Frontiers in surgery
DO  - 10.3389/fsurg.2026.1853640
UR  - https://europepmc.org/article/MED/42898411
AB  - Periapical lesions persisting after root canal treatment, particularly those radiographically suggestive of true cysts, often necessitate surgical management. This report introduces a synergistic technique for precise periapical surgery in anatomically challenging areas, combining a 3D-printed osteotomy guide with an ultrasonic bone scalpel. A personalized, tooth-supported osteotomy guide was designed based on fused cone-beam computed tomography (CBCT) and intraoral scan data to ensure accurate localization of the lesion and minimal buccal bone window dimensions. An ultrasonic bone scalpel was then employed to execute the planned osteotomy, facilitating the reflection of a buccal bone lid that remained attached to the mucoperiosteal flap. Following complete cyst enucleation and apical resection, retrograde root canal filling was performed under microscopic vision. The pedicled bone lid was subsequently repositioned to promote healing and prevent soft tissue ingrowth. This combined protocol effectively addresses the challenges of limited visibility and access in the posterior maxilla, demonstrating a precise and minimally invasive approach for managing complex periapical lesions.
SN  - 2296-875X
ER  -