Endodontic Management of Pulp Canal Obliteration Using a New Single-Tooth Template

Abstract

Background: Guided Endodontics is suggested as a reliable method for management of teeth with pulp canal obliteration (PCO). The guide used for this usually involves multiple teeth to gain stability but is bulky. It is therefore suboptimal to be used along with rubber dam. Aim: To describe the use of a minimized single-tooth guide template in three patients with radiographic evidence of PCO. Design: The template was designed and fabricated using the cone-beam computed tomography (CBCT) scan and a surface scan image of the involved teeth. In all three patients, the root canals were successfully negotiated within 15 minutes, with the template involving only the tooth in focus or with neighboring half of the teeth. The operator stabilized the template if required. Conclusions: This case series shows clinically that successful outcome can be obtained during guided endodontics with the use of a single-tooth template in previously traumatized anterior teeth with PCO.

Clinical Endodontic Applications of 3D Printing, A Review

“…Guides have been effective in allowing treatment in a variety of complex cases, including that of a maxillary lateral incisor with pulp canal obliteration, a maxillary central incisor with root perforation in the middle third, and a pulp canal obliteration in the apical third [11,14,23]. This review included multiple case reports using guides specifically for pulp canal obliteration cases [24][25][26][27]. Guided endodontics allows clinicians to gain access to canals they may not have attempted otherwise.…”

“…The additive size of the guide, bur, and handpiece may make treatment of posterior teeth unfeasible due to limited interocclusal space [4,14]; currently new designs in the 3D guides are coming up to counter this challenge like single-tooth templates [26] and, 3D inlay guides [83] which were less bulky than traditional 3D guides. Connert et al stated that surgical guides are most effective on 'straight rooted' teeth.…”

Tooth substance loss after incisal endodontic access and novel single-tooth template-guided endodontic access in three-dimensional printed resin incisors with simulated pulp canal calcification: A comparative in vitro study

“…Recently, a new single-tooth template has been fabricated to overcome the drawbacks of bulky guides. [ 13 ] Its practicality has been tested in some case reports;[ 13 ] however, its efficacy for endodontic access opening is yet to be assessed.…”