Digital Planning on Guided Endodontics Technology

Abstract

The aim of this review is to discuss the digital planning and the use of guided technology in Endodontics. The complexity of the root canals anatomy and the challenges in the microorganism’s control represent risk factors for failure after the infected root canal’s treatment. Scientific improvements associated with technological advances have enabled better predictability of therapeutic procedures results. The development of efficient and modern devices provided safer root canal treatments, with shorter clinical visits and greater patient comfort. Digital endodontics incorporated different tools and developed its own, advancing even further in resolving complex cases. The faithful copy of the internal anatomy provided by the advancement of CBCT devices and software’s, associated with the digital resources of 3D planning and printing, enabled the advent of guided endodontics. This technique is used at different stages of endodontic treatment, with specific indications and greater result predictability. Therefore, this study critically reviewed the potential clinical application of this guided access technique, and the operative steps for its safe performance in managing complex endodontic cases. The main indications are accessing calcified root canals, performing endodontic surgeries in difficult access areas, removing fiberglass posts, and accessing teeth with developmental anomalies. In summary, guided endodontics has been a precise strategy, effective, safe, and clinically applicable. This procedure represents incorporating technological resources and digital planning in the Endodontist clinical practice, increasing predictability to complex cases.

Three‐dimensional accuracy of endodontic access preparations using novel nonrestrictive static guides: A laboratory study

“…Therefore, access preparations by current restrictive static endodontic guides in teeth with normal anatomies, which resembles truss and UltraCA, have several potential drawbacks on the endodontic treatment and no added value for enhancing fracture resistance compared with ConsAC. Additionally, accurate positioning of the drill to target the canal in a straight trajectory by conventional restrictive guides, frequently leads to cavity margins placed at areas of occlusal contacts as cuspal ridges or incisal edges, compromising long‐term stability of the tooth restoration interface [30].…”

Guided Endodontics as a Personalized Tool for Complicated Clinical Cases

“…The main disadvantage of guided endodontics may be the additional cost of procedures and materials such as CBCT, 3D printers, and resin. The guided technique can also be used when removing fiberglass posts [ 25 , 27 , 28 ] or during the treatment of teeth with developmental anomalies, e.g., dens invaginatus [ 29 , 30 ] or dentin dysplasia [ 31 ]. In the four presented cases, all calcified root canals were properly treated using endodontic guides.…”

Endodoncia Guiada Estática, Una Opción para Obliteración del Canal Pulpar. Serie de Casos

“…La endodoncia digital ha incorporado diferentes elementos y desarrollado otros, para avanzar en la resolución de casos complejos. El avance en el uso de CBCT y de los software asociados a la planificación e impresión 3D, ha promovido el desarrollo de la endodoncia guiada (Decurcio et al, 2021). En relación a la planificación digital de este caso, uno de los aspectos críticos a tener en cuenta son los aspectos técnicos mínimos de un equipo CBCT para ser utilizado en la confección de guías, tales como: tamaño de voxel inferior a 100 um; posibilidad de adquisición de examen con tamaño de ventana (FOV) de 5x5 cm o inferior, ángulos de giro superiores a 180° y posibilidad de modificación del KV y mA.…”

“…La técnica de endodoncia guiada puede dividirse en dos fases, una fase de laboratorio para la producción de la guía endodóntica, en la cual la mayoría de los procesos se realizan sin el paciente y con la ayuda de herramientas digitales. La otra fase es la clínica, donde se aplica la guía a los procedimientos operatorios (Decurcio et al, 2021).…”