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

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.