This study is to compare the clinical and radiographic outcomes after guided periapical endodontic surgery versus conventional endodontic surgery.

The aim of this study is to compare the clinical and radiographic outcomes after guided periapical endodontic surgery versus conventional endodontic surgery. Patients having mandibular posterior teeth indicated for endodontic surgery will be selected. Full medical and dental history will be obtained from all patients. Patients will be randomly assigned to either guided endodontic surgery or conventional endodontic surgery. Surgical procedures will be done under magnification. Root-end cavities will be filled using MTA.Post surgical instrucions will be given to patients. Surgical time will be recorded. Clinical and radiographic success will be asses at 6 and 12 month.

Inclusion Criteria:

1. Patients in good general health.
2. Patients with age ranging between 18-50 years with no sex predilection.
3. Posterior teeth with an indication for endodontic surgery.
4. Patients' acceptance to participate in the study.

Exclusion Criteria:

1. Patients with allergy to materials or medications used in the trial.
2. Pregnant female patients.
3. Teeth with pathoses associated with vertical root fracture.
4. Severe periodontal bone loss detected with a periodontal probe (5 mm probing depth).