Endo Microsurgery

15/05/2026

06/02/2026

Heartfelt thanks to the University of Oslo for the invitation, and to ClaroNav and Luca Casalena for the support in delivering a lecture on the advancements of endodontic microsurgery—particularly in dynamic navigation.
A highly engaged group of endodontists and periodontists showed great interest in understanding how Navident and dynamic navigation work and how they can enhance surgical precision.

09/05/2025

A heartfelt thank you to the Endodontic Association of Guatemala for the kind invitation to present this webinar on endodontic microsurgery.
Join me on Tuesday, May 27th at 20:00 CET for a deep dive into the role of piezosurgery and the application of the bony lid technique in modern endodontic microsurgery.
🌍 The session is open to colleagues from around the world — I’d be glad to see you there!
👉 Registration link is in my bio.

28/04/2025

"Know where to cut ✂️🦷"

When performing a submarginal incision during endodontic microsurgery, precision is everything.
🔹 Step 1: Distinguish mucosa from gingiva, identifying the mucogingival junction.
🔹 Step 2: Differentiate free from attached gingiva through careful probing.

The submarginal incision should be placed in the middle of the attached gingiva, maintaining:
✅ At least 2mm of attached tissue on both sides
✅ Adequate distance from the lesion

These considerations help minimize scar tissue formation and promote optimal healing.

In this case, the abundance of attached gingiva allowed ideal flap design.
A small flap and fast surgery enabled passive reapproximation, secured with 9-0 nylon sutures.

✨ At 1-month follow-up, we observe excellent healing — while scar tissue from a previous, wrongly placed semilunar incision remains visible.

31/03/2025

Endodontic microsurgery of the upper left first molar presented an unexpected challenge when the floor of the sinus was already perforated due to the expansion of the lesion from the MB root. A bony lid technique was employed using piezosurgery to access the site.

During curettage, a sinus membrane perforation occurred. To manage this, I enlarged the osteotomy around the perforation’s borders, facilitating the lift of the membrane. A second window was created, exposing the membrane. Once lifted, I was able to access the palatal defect.

Before closure, a collagen membrane was placed in contact with the perforation to prevent bone graft extravasation into the sinus, ensuring proper healing.

It’s always about adapting to the challenges and finding the best solution for the patient’s outcome! 💉🔬🦷

19/03/2025

"Through & Through Cyst Removal: Precision in Managing Critical Structures"

In this case, CBCT imaging was crucial in evaluating the extent of the lesion—not only confirming the through-and-through defect but also highlighting its proximity to key anatomical structures, including the nasal floor and the nasopalatine nerve.

🔬 Surgical Approach:
✔ Complete enucleation of the cyst and surgical retreatment.
✔ Placement of a collagen membrane against the nasal floor and nasopalatine nerve.
✔ Augmentation with allograft (70/30 - FDBA/DFDBA).
✔ A second collagen membrane was placed at the buccal aspect for soft tissue cell exclusion.

Meticulous planning and ex*****on are key in managing such extensive defects while preserving surrounding structures.

15/03/2025

Needle choice matters! ✨ In endodontic microsurgery, using the right suture can make all the difference in preventing tissue trauma and ensuring optimal healing. 🦷🔬

Initially, a 7.0 polypropylene suture with a 13mm needle was used. However, in the danger zone—where gingival tissues were thinner at the transition angle of the flap—this needle risked tearing the tissue or entering the sulcus. Instead, a 9.0 nylon suture with a 6mm 1/2 needle was used, allowing for safer passage and precise tissue engagement.

📍 The result? At 1-week post-op, healing was excellent! ✅