Microguided Endodontics: a case report of a maxillary lateral incisor with pulp canal obliteration and apical periodontitis

Abstract

Aim To describe a minimally invasive method to create a 3D‐printed guide to gain access to obliterated root canals on the basis of CBCT data. Summary A 85‐year‐old female ASA III was referred for root canal treatment of tooth 22. Clinically, there were no complaints, no percussion pain or sinus tract. Radiologically, the tooth had an obliterated canal with an apical radiolucency. The tooth was diagnosed with asymptomatic apical periodontitis. Microguided Endodontic treatment was performed with the help of a 3D‐printed guide. The root canal was localized initially with the aid of the 3D‐printed guide using a round carbide bur with a head diameter of 0.8 mm. Then, the canal was shaped and cleaned using mechanical rotary files under copious irrigation with 5% NaOCl, 17% EDTA and passive ultrasonic activation. A completely healed apical area of tooth 22 was visible after 6 months on periapical radiographs and small field of view CBCT. Key learning points Using the Microguided Endodontics concept, a minimally invasive access was achieved up to the middle of the root, in a maxillary lateral incisor with pulp canal obliteration (PCO) and apical periodontitis. This technique is a valuable tool for the negotiation of PCO, reducing chair time and risk of iatrogenic damage to the root.

Cone beam computed tomography in Endodontics – a review of the literature

“…The benefits of guided access cavity preparation include conservative access cavity preparation, decreased chair time and reduced risk of iatrogenic damage (Torres et al . , Connert et al . ).…”

“…Stents with guide sleeves have been 3D printed from optical surface scans and CBCT data sets to allow guided access cavity preparation (Connert et al 2019). The benefits of guided access cavity preparation include conservative access cavity preparation, decreased chair time and reduced risk of iatrogenic damage (Torres et al 2018, Connert et al 2019).…”

PRICE 2020 guidelines for reporting case reports in Endodontics: explanation and elaboration

“…From Torres et al (2019) – ‘The CBCT revealed a calcified root canal up to the apical third of the root and an apical radiolucency of 39.8 mm 3 , and the buccal bone plate was preserved.…”

Applications of nano-materials in diverse dentistry regimes

“…Nonetheless, cleaning and restoration with sub-gingival margins is difficult so that it would augment the developing periodontitis and loss of the tooth's attachment. [135][136][137] Hence, it is necessary to develop a bio-active Class V composite for eliminating secondary caries and root caries.…”