TREATMENT OF YATROGENIC POST-TRAUMATIC NEUROPATHY ASSOCIATED WITH ENDODONTIC THERAPY USING 3D TECHNOLOGIES

Abstract

Post-traumatic neuropathy is one of the complications of endodontic treatment, represents a serious problem, manifested by sensory disturbances and has a significant negative impact on the quality of life of patients. Mechanical pressure on the filler causes swelling and hematoma and, due to the chemical action of the substance, neurotoxicity. The decision to treat a patient with trigeminal neuropathy requires complex treatment. Early surgical removal of excess endodontic material resulting from endodontic treatment provides the best prognosis for recovery. With the development of modern digital technologies, advances have been made in the endodontic treatment process. The presented clinical case describes original method for the treatment of endodontic inferior alveolar nerve injuries associated with endodontic therapy using surgical template obtained by three-dimensional software modeling. Using computed tomography software, a template was developed for drilling the bone in the projection of the localization of the material. The surgical template is printed with a 3D printer, after installation in the oral cavity, osteotomies are made under X-ray and excess material is removed, after which the patient is prescribed complex treatment. Results: After 2 weeks, the patient's complaints disappeared. Sensory impairments were restored and had a positive impact on the patient’s quality of life. A control X-ray examination revealed regeneration of young bone tissue at the osteotomy site. Conclusion: The introduction of digital planning software and the use of 3D printed surgical guides in endodontic microsurgery have significantly improved treatment planning as well as operative and psychological comfort for patients.