Guided endodontics a pathbreaking approach to the management of calcified canals: A case report

Abstract

Abstract Pulp calcification refers to the accumulation of hard tissue in the root canal space as a response to dental trauma. Despite being a common finding in dental practice, access to an obliterated pulp chamber and subsequent canal negotiation remains challenging for clinicians due to the increased likelihood of iatrogenic errors such as gouging, ledging, or perforation. In this current report, a 21-year-old male patient presented with a discolored maxillary central incisor and reported a history of trauma that occurred 15 years ago. The tooth exhibited sensitivity to percussion; with no vestibular obliteration or periodontal pockets. Intraoral periapical radiograph revealed a completely calcified root canal associated with apical widening, suggestive of apical periodontitis. A 3D-printed endodontic guide was fabricated using the cone beam computed tomography (CBCT) images and digital planning software to aid in locating the root canal orifice. The canal was successfully navigated with the help of the endodontic guide, and a 12-month follow-up revealed that the patient remained clinically asymptomatic, with radiographic evidence indicating periapical healing. For conservative, precise, and predictable outcomes, a digital workflow that makes use of CBCT imaging, planning software, and a 3D-printed endodontic guide may be taken into consideration when managing extensively calcified canals.