The purpose of this ex vivo study was to determine the accuracy of template-based guided endodontics for access cavity preparation and root canal detection in posterior teeth. First, three maxillary and four mandibular models were constructed using 67 premolars and molars, with a total number of 135 main root canals. Cone beam computed tomography (CBCT) and three-dimensional 3D surface scans of each model were performed and matched in order to plan access cavity preparation and design templates virtually. Template-guided access cavity preparation was then performed for each tooth, followed by postoperative CBCT scanning. Deviations between planned and prepared access cavities were measured after superimposition of the pre- and postoperative CBCT scans, and they were analyzed using descriptive and multivariate statistics. All root canals (135/135) were detected utilizing guided endodontics. The mean angle deviation was 1.4 degrees, and the mean deviations at the tip and base of the bur were 0.24–0.31 mm and 0.26–0.29 mm, respectively. This study demonstrated that guided endodontics is an accurate and predictable method for endodontic access cavity preparation in posterior teeth.
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