Guided endodontic access of severe calcified tooth without incisal edge – case report: Guided endodontic access

Esteban Isaí Flores Orozco; Amjad Abu Hasna; Guilherme Schmitt de Andrade; Vinícius  de Carvalho Machado; Luiz Roberto  Coutinho Manhães Junior; Guilherme  de Siqueira Ferreira Anzaloni Saavedra

doi:10.4322/bds.2022.e3145

Authors

Esteban Isaí Flores Orozco Universidade Estadual Paulista, Institute of Science and Technology, Endodontics Division, Department of Restorative Dentistry. São José dos Campos, SP, Brazil. http://orcid.org/0000-0003-1658-5181
Amjad Abu Hasna Universidade Estadual Paulista, Institute of Science and Technology, Endodontics Division, Department of Restorative Dentistry. São José dos Campos, SP, Brazil. https://orcid.org/0000-0002-1112-985X
Guilherme Schmitt de Andrade Universidade Estadual Paulista, Institute of Science and Technology, Department of Prosthodontics and Dental Materials. São José dos Campos, SP, Brazil. http://orcid.org/0000-0002-5697-2947
Vinícius de Carvalho Machado Faculdade São Leopoldo Mandic de Belo Horizonte (SLM-Campinas), Faculty of Dentistry, Department of Radiology. Belo Horizonte, MG, Brazil. http://orcid.org/0000-0002-3089-5138
Luiz Roberto Coutinho Manhães Junior Universidade Estadual Paulista, Institute of Science and Technology, Department of Diagnosis and Surgery. São José dos Campos, SP, Brazil. http://orcid.org/0000-0003-1642-5241
Guilherme de Siqueira Ferreira Anzaloni Saavedra Universidade Estadual Paulista, Institute of Science and Technology, Department of Prosthodontics and Dental Materials. São José dos Campos, SP, Brazil. http://orcid.org/0000-0001-7108-0544

DOI:

https://doi.org/10.4322/bds.2022.e3145

Abstract

Pulp tissue may suffer calcification because of trauma, operative procedures or carious lesions. This paper aimed
to report and discuss the guided endodontic access as an alternative treatment. A 52 years old female patient had
severe root canal calcification of tooth #11 associated with a radiolucent periapical lesion. Firstly, the crown and
metal post and core were removed. A digital impression and cone-beam computed tomography “CBCT” scans
were performed and imported to implant planning software (SimPlant Version 11; Materialise Dental, Leuven,
Belgium).The guided endodontic access template was designed to allow the drill to reach a distance of 2 mm
short of the apical foramen, once printed, it was tested in the mouth to evaluate its insertion and stability in the
dental arch. The calcified root canal was penetrated using the access drill rotating by a low-speed hand-piece
(10,000 rpm) under saline solution irrigation through advancing movements. Then, the apical foramen was
negotiated with C-Pilot files #10 and #15. The working length was measured using the iPex-II apex locator.
The instrumentation was carried out with Reciproc R50 and 2.5% sodium hypochlorite. One week later, a fullceramic
crown preparation was performed, and polyvinyl siloxane impression was carried out. A total of three
follow-up sessions were performed after one week, one and twelve months. Bone neoformation was observed in
the site of the periapical lesion and the patient had no signs or symptoms of any discomfort. Therefore, guided
endodontics is indicated for severe calcified root canals.
KEYWORDS
Guided endodontics; Calcified root canals; Access cavity.

Guided endodontic access of severe calcified tooth without incisal edge – case report