Computer-Guided Biopsy of Osteosclerotic Jaw Lesion Using 3D-Printed Surgical Guides: A Fully Digital Workflow

Osteosclerotic jaw lesions, often incidentally detected on routine radiographs, are rarely biopsied due to their benign appearance and proximity to delicate anatomic structures. This case report presents a fully digital workflow for guided biopsy of a deep mandibular osteosclerotic lesion, integrating artificial intelligence-based segmentation, intraoral scanning, CAD design, and 3D printing of surgical templates. A 3D-printed guide with depth-control stops was used to safely and precisely position trephine burs between the roots of tooth 4.6 and the mandibular canal. The approach allowed accurate tissue sampling for histopathologic diagnosis (osteoma), minimizing invasiveness and risk to adjacent structures. Postoperative CBCT confirmed the accuracy of the biopsy, with deviations of 0.6 mm (linear), 4 degrees (angular), and −0.2 mm (depth). This technique demonstrates the potential of artificial intellingence-assisted digital planning and 3D printing to enhance biopsy precision for intraosseous lesions.