Guided Endodontics as a Personalized Tool for Complicated Clinical Cases

Wojciech Dąbrowski (), Wiesława Puchalska, Adam Ziemlewski and Iwona Ordyniec-Kwaśnica
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Wojciech Dąbrowski: Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland
Wiesława Puchalska: Department of Paediatric Dentistry, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland
Adam Ziemlewski: Private Practice Impladent Medical & Dental Clinic, 80-125 Gdansk, Poland
Iwona Ordyniec-Kwaśnica: Department of Dental Prosthetics, Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland

IJERPH, 2022, vol. 19, issue 16, 1-19

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.

Keywords: guided endodontics; computer-aided design; computer-aided manufacturing; digital imaging; pulp canal obliteration; endodontic guide; root canal treatment (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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