Targeted Endodontic Microsurgery (TEMS) was pioneered at the Air Force Postgraduate Dental School and appeared on the cover of the April 2018 Journal of Endodontics. It combines the use of trephine burs (traditionally used to remove implants) with 3D printed surgical guides to perform osteotomy, root-end resection and biopsy in a single 60-second step. TEMS represents a substantial leap forward because it allows access to previously prohibitive anatomic sites. The presentation contains substantial video footage and details the use of TEMS in several anatomically challenging scenarios, such as a mandibular second molar, and the palatal root of the maxillary 2nd molar. General concepts of digital workflow and stent design will be introduced and speculations about the future of 3D printing in endodontics will be discussed.