Case Report/Clinical TechniquesGuided Endodontics for Managing Severely Calcified Canals
Section snippets
Case Report
Seven consecutive adult patients (aged 27–53 years, mean age = 40.5 years) with a previous history of dental trauma experiencing tooth discomfort in the anterior region were referred to the dental office (endodontic referral clinic in Barcelona, Spain) between 2015 and 2017. No teeth responded to thermal or electric pulp testing (Fig. 1A), although sensitivity to palpation was observed in 4 cases and to percussion in 2 cases (Table 1). Radiographic examination, which included a periapical
Discussion
McCabe and Dummer18 used a treatment decision flowchart to determine that procedures on PCO teeth should be limited to cases with symptomatic and/or radiographic signs of periapical pathosis. They also suggested that endodontic treatment should be considered for discolored teeth that were unresponsive to vital bleaching techniques. However, in their flowchart, radiographic assessment was limited to intraoral radiographs, which may be insufficient for proper visualization of the root canal
Conclusion
Within the limitations of the present report, guided endodontics was demonstrated to be a safe, accurate, and conservative approach for the endodontic management of severely anterior obliterated canals when precise virtual planning is used. CBCT imaging should be used to determine the need for guided endodontic access depending on the degree of tooth obliteration. Additional research should focus on comparing different planning software, materials, and designs for both 3D guides and burs.
Acknowledgments
The authors thank the staff members of Autrán Dental for its logistic contribution and Jesús Muñoz for his assistance with the digital planning. The authors deny any conflicts of interest related to this study.
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