Minimally invasive treatment of calcified root canals in anterior teeth with digital guide technique

doi:10.7518/hxkq.2022.01.017

Abstract

Abstract: Objective

This study aims to establish a minimally invasive treatment using a customized digital template and a miniaturized bur for pulp canal obliteration (PCO).

Methods

Cone-beam computed tomography (CBCT) and digital oral scans of patients diagnosed with PCO in anterior teeth were obtained. Root canal morphology was reconstructed to accurately show the location, length, and direction of obliteration. A digital template was designed and fabricated using visual design software and 3D printing technology and used as guide for the miniaturized bur and drill sleeve during calcified tissue removal. A conventional root canal treatment was performed after the lumen of the root canal was reached.

Results

In both cases, the planned access cavity and glide paths were successfully established. In case 1, the deviated angle of the access cavity was 1.37°±0.07°, the deviation at the bottom of the miniaturized bur was 0.08-0.81 mm, the deviation at the tip of the bur was 0.05-1.13 mm, and difference in substance loss was 0.84-4.25 mm³. In case 2, the deviated angle of the access cavity was 3.09° ± 0.12°, the deviation at the bottom of the bur was 0.09-0.68 mm, the deviation at the tip of the bur was 0.29-0.66 mm, and the difference in substance loss was 0.55-3.79 mm³.

Conclusion

Micro-guided endodontics is a novel approach for localizing and negotiating obliterated root canals and guarantees long-term prognosis without requiring excessive hard tissue removal.

Key words: guided endodontics, minimally invasive endodontics, pulp canal obliteration, digital template

CLC Number:

R 781.05

Gao Yuxuan, Wang Liu, Fu Yujie, Yang Fan, Zhang Lan, Huang Dingming. Minimally invasive treatment of calcified root canals in anterior teeth with digital guide technique[J]. West China Journal of Stomatology, 2022, 40(1): 111-122.

Figures/Tables 11

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Tab 1

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项目		病例1（11牙）	病例2（31牙）
角度偏差/°		1.37±0.07 （1.27~1.46）	3.09±0.12 （2.93~3.21）
基底部偏差/mm	近远中向	0.70±0.02 （0.68~0.73）	0.63±0.02 （0.60~0.68）
	颊舌向	0.79±0.01 （0.78~0.81）	0.53±0.03 （0.49~0.56）
	冠根向	0.13±0.02 （0.08~0.15）	0.11±0.01 （0.09~0.12）
根尖部偏差/mm	近远中向	0.25±0.03 （0.22~0.28）	0.59±0.03 （0.58~0.66）
	颊舌向	0.07±0.02 （0.05~0.10）	0.37±0.05 （0.34~0.43）
	冠根向	1.10±0.01（1.08~1.13）	0.31±0.02（0.29~0.35）

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