Guided Endodontics as a Personalized Tool for Complicated Clinical Cases

Abstract

The aim of this paper is to present a technique to individualize root canal localization in teeth with calcified root canals using a digitally planned, 3D-printed endodontic guide. Root canal calcification is characterized by the apposition of tertiary dentin along the canal wall. The endodontic treatment of teeth with calcified canals is often challenging. However, digital dentistry meets these challenges. Merging CBCT images with an intraoral scan allows a clinician to prepare an endodontic guide. This article describes the clinical and digital workflow of the guided endodontic access approach in teeth with difficulties in terms of root canal localization due to post-traumatic pulp canal obliteration (PCO) and canal calcification in elderly patients. The path of entry into the root canal system was planned using cone-beam computed tomography (CBCT). The template was printed on a 3D printer using transparent resin. During root canal treatment (RCT), the endodontic tool was inserted through the sleeve until the desired location was reached. The use of an endodontic guide allowed for minimally invasive RCT, avoiding the excessive loss of tooth structures. Navigated endodontics enables clinicians to perform RCT in a more predictable manner and allows clinicians to avoid iatrogenic complications, which improves the treatment prognosis.

The investigation of WNT6 and WNT10A single nucleotide polymorphisms as potential biomarkers for dental pulp calcification in orthodontic patients

“…The calcification of the dental pulp, partially or completely, is one of the ways that the dentin-pulp complex reacts by repairing under damage. This mechanism directly affects clinical approaches, such as endodontic treatment [4].…”

Revolutionising conservative dentistry: Exploring the impact and evolution of digital impression techniques in contemporary dental practice

“…While direct evidence on the application of digital impression techniques in endodontic procedures may be lacking, the broader strides in digital dentistry have undeniably elevated the precision and predictability of root canal therapy. [23][24][25] Digital impression techniques are pivotal in the fabrication of dental implants and prosthetics, offering notable advantages over traditional methods. Research demonstrates the accuracy of digital impressions in crafting implant-supported crowns and fixed dental prostheses (FDPs), particularly in cases involving one or two contiguous dental implants.…”

An update on guided endodontics

“…Within surgical endodontics, it plays an important role as it helps to measure the distance between the cortical plate and the apex, the position of the roots within the bone and the proximity of vital structures [22] . CBCT imaging allows locating the visible part of the root canal and planning the access route to the root canal system while preserving the cervical dentin [23] . CBCT applications in endodontics involve the shift from analog to digital imaging and advances in imaging theory and volume acquisition data, allowing detailed 3D images [24] .…”