Cirugía perirradicular guiada con láser Erbium Er CR: YSGG. Reporte de caso

Abstract

Purpose: To observe the bone healing process following guided periradicular surgery using Erbium Er Cr:YSGG laser for osteotomy in the postgraduate endodontic program at Santo Tomas University. The evaluation was conducted via cone-beam computed tomography (CBCT) during the initial four months post-surgical intervention. Materials and Methods: After clinical history documentation and tomography analysis, a patient diagnosed with symptomatic apical periodontitis, displaying a periapical lesion smaller than 5mm with intact vestibular cortical bone, necessitating periradicular surgery due to proximity to the mental foramen and an existing fixed prosthesis, was selected. Treatment planning, surgical guide design, and osteotomy using Erbium Er Cr:YSGG laser were executed. The size of the periradicular lesion and bone density in the surgical area were measured at three timepoints: pre-surgery (T0), 24 hours post-surgery (T1), and at 4 months (T2). Results: Bone density, measured in Hounsfield Units via CBCT, revealed preoperative values at the apical vestibular site of 1478 and 1435 UH at T0, -95 and -210 UH at T1, and 992 and 860 UH at T2. In the coronal section at the mid-level, the preoperative value (T0) was 1335 UH, -18 UH at T1, and 1269 UH at T2. Conclusions: Utilizing guided surgical techniques and Erbium laser for osteotomy reduced adverse effects, yielding more accurate and favorable outcomes in surgical procedures, leading to improved prognoses.