Kuczmaja Monika, Żółtowska Agata
Department of Conservative Dentistry, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland.
J Clin Med. 2025 Jun 9;14(12):4079. doi: 10.3390/jcm14124079.
A 19-year-old female patient reported to the Department of Conservative Dentistry, Medical University of Gdańsk, with pain in the left lateral incisor. During the attempt to perform root canal treatment on tooth 22, we encountered difficulties in locating the canal opening, which resulted in treatment failure. Radiographic examinations revealed Pulp Canal Obliteration and a root fracture with a double fracture line, resulting in two root fragments. The prognosis for this tooth was poor, with extraction being the most likely outcome. To provide effective therapy, a 3D-printed endodontic guide was utilized, allowing for more precise localization of the canal in a tooth with a calcified root canal and complex fracture morphology. An intraoral scan and cone-beam computed tomography (CBCT) were performed, followed by the design of the guide. This facilitated accurate planning of the entry path for endodontic instruments, promoting minimally invasive treatment and reducing the loss of tooth structure. Through navigated endodontics, the treatment became more predictable, and the risk of iatrogenic complications was minimized, significantly improving the prognosis of the therapy. Clinical and radiological examinations conducted after 12 months demonstrated successful treatment and preservation of the tooth in the oral cavity. The obtained results suggest that the use of guided endodontics can improve outcomes in cases with pulp canal obliteration and complex fractures, offering a minimally invasive and predictable approach.
一名19岁女性患者前往格但斯克医科大学保守牙科就诊，主诉左侧侧切牙疼痛。在尝试对22号牙进行根管治疗时，我们在确定根管口位置时遇到困难，导致治疗失败。影像学检查显示牙髓腔闭塞，牙根骨折且有两条骨折线，形成两个牙根碎片。该牙预后不佳，最有可能的结果是拔除。为了提供有效的治疗，使用了3D打印的根管治疗导板，使得在根管钙化且骨折形态复杂的牙齿中能更精确地定位根管。进行了口腔内扫描和锥形束计算机断层扫描（CBCT），随后设计导板。这有助于精确规划根管治疗器械的进入路径，促进微创治疗并减少牙体组织的损失。通过导航根管治疗，治疗变得更可预测，医源性并发症的风险降至最低，显著改善了治疗预后。12个月后进行的临床和影像学检查表明治疗成功，牙齿得以保留在口腔内。所得结果表明，使用引导式根管治疗可改善牙髓腔闭塞和复杂骨折病例的治疗效果，提供一种微创且可预测的方法。
