Endodontia guiada: um avanço no acesso endodôntico de canais calcificados

Abstract

Pulp calcifications are due to the deposition of mineralized tissue in the pulp space, discovering complete or partial obliteration of this region. Endodontic treatment of teeth with pulp calcifications can be a challenge, due to the difficulty in locating the root canal. Recently, a new technique known as "Guided Endodontics" has been incorporated into the endodontic treatment of calcified canals, enabling faster and safer cavitary access and instrumentation. A 27-year-old male patient presenting pain in the right upper incisor was part of the case study conducted. The patient had a history of orthodontic treatment that lasted 5 years. Clinical examination revealed the presence of percussion sensitivity and negative response to thermal and electrical tests. Digital radiographs showed calcified pulp chamber and partially calcified root canal. A CBCT and intra-oral scan of tooth 11 were performed for virtual planning, which allowed the subsequent preparation of the model and the conservative access up to the apical third of the root. In this technique, the 3D printed model accurately directs a specific drill into the root canal. Subsequently, conventional canal treatment was performed. The present case study demonstrates that the guided endodontic technique is feasible and promising, since it allows minimally invasive access and an important clinical time reduction when compared to the conventional method.