Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report

Abstract

Background To report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia with pulp canal calcification (PCC) and apical periodontitis based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.Case presentation A 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth. Conclusions In patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.

Present status and future directions – Guided endodontics

“…The clinical implementation of guided endodontics has been demonstrated in various further case reports published during the past 5 years (Buchgreitz et al, 2019a;Casadei et al, 2020;Fonseca Tavares et al, 2018;Hegde et al, 2019;Ishak et al, 2020;Kamburoğlu et al, 2021;Krug et al, 2020b;Lara-Mendes et al, 2018a, 2018bLlaquet Pujol et al, 2021;Loureiro et al, 2021;Maia et al, 2019;Tavares et al, 2020;Todd et al, 2021;Torres et al, 2019).…”