Introduction: Managing impacted teeth, especially those in unusual positions and near vital structures, presents significant clinical challenges. Traditional imaging methods, such as periapical, occlusal, and panoramic radiographs, are limited by their two-dimensional nature, often necessitating larger flap elevations and greater bone removal, which increases surgical trauma. Aim: This study aimed to evaluate the use of virtual surgical planning on cone beam computed tomography (CBCT) scans to fabricate Position Indicating Impaction Guides (PIIGs) that minimize surgical trauma in the management of impacted teeth. Materials and Methods: After institutional review board approval, a pilot study was conducted involving three patients with impacted teeth. CBCT scans were obtained, and surgical planning was carried out using the PIIG protocol. Custom surgical guides were designed based on the protocol and three-dimensionally printed using a Phrozen Sonic Mini 4K printer. The surgical procedures were executed using these guides to assist in locating the impacted teeth. Results and Discussion: The guides were successfully positioned intraorally with accurate fit verification. All three cases demonstrated that the guides effectively localized the impacted teeth. Incorporating offset measurements during guide design enabled precise surface contact with the impacted teeth, reducing the need for extensive surgical exposure and minimizing trauma. Conclusion: PIIGs proved to be effective in localizing impacted teeth while reducing surgical trauma to adjacent structures. This technique shows promise as a minimally invasive, patient-friendly approach to managing impacted teeth.
Chennoju et al. (Thu,) studied this question.