Deducing a surgical dilemma using a novel three dimensional printing technique.

Persistent apical periodontitis even after nonsurgical retreatment demands for a surgical approach. This requires a thorough diagnosis and planning to eliminate the pathology and induce healing. This is sometimes challenging when the pathology is present in close relationship to the vital structures. In such cases, modern, sophisticated technology such as three-dimensional (3D) printing can come very handy in patient education as well as for planning and mock-up preparation of the surgery. In this case, a nonhealing persistent apical periodontitis in relation to 16 was surgically treated. However, the pathology was in close association with the maxillary sinus hence fused deposition modeling-based 3D printed models were fabricated for patient education and to locate and determine the extent of the lesion. This was followed by the surgical enucleation of the lesion and apicectomy of mesiobuccal and distobuccal roots and mineral trioxide aggregate retro-filling and as the symptoms subsided after the follow-up full coverage metal crown was fabricated and cemented. This technology has opened a new horizon for the use of 3D printing in conjugation with endodontic principles for more predictable endodontic success.