Endodontia guiada por tomografia computadorizada de feixe cônico: aplicações clínicas e direções futuras

Abstract

The use of modern technologies in endodontics such as CBCT and CAD/CAM have increased accuracy in planning and in execution of endodontic treatment and also, helped professionals to overcome challenges in clinical practice. Based on a literature review, the goal of this paper was elucidating the clinical applicability of the guided endodontic technique, describing the technique with advantages and disadvantages, and also point the future directions of this technique. The Pubmed and CAPES journals databases were consult, in the English language, with data from 2016 to 2022. It was possible to see that guided endodontics has been developing and expanding it indications. Several studies have been described the effectiveness and the applicability of guided technique not only for localization of severely calcified canals, but also in the endodontic reintervention of teeth restored with fiber pins and MTA, and in the treatment of dens invaginatus and also in paraendodontic surgeries. This technique allows a larger preservation of tooth structure, less chair time and prevention of iatrogenic damage, it is possible to be done by a less experienced professional without the use of a surgical microscope as well. Limiting factors such as interocclusal space requirement, straight line access and root thickness may be encountered when using this new approach. Moreover, some disadvantages should be considered such as additional cost, planning time, number of visits, radiation exposure by CBCT and the use of implant burs. In conclusion, guided endodontics has been shown accuracy in locating the root canal holes in complex cases, reducing the risk of iatrogenesis and providing the more longevity of the treated tooth, i.e., it is determinant that this new approach allows the production of promising results for endodontic treatments. However, it is worth emphasizing the need for further studies and research that evaluate the accuracy of the guided endodontic technique.