Cone-beam computed tomography-guided endodontics
clinical applications and future directions
DOI:
https://doi.org/10.47385/cadunifoa.v19.n54.4466Keywords:
CAD-CAM, Endodontics, Cone beam computed tomography, pulp cavityAbstract
Introduction: One of the major problems of endodontic treatment is access to the pulp chamber and root canal when calcified or obstructed. Objective: The purpose of this study was to review the literature on guided endodontics regarding clinical applications, techniques, advantages and disadvantages, as well as future perspectives. Material and Methods: Pubmed databases and CAPES journals were consulted, in English, between 2016 and 2022. Results: 28 clinical case reports, eight in vitro studies and five ex vivo studies were selected. The technique consists of fusion of cone beam computed tomography (CBCT) data and intraoral surface scanning in order to guide the drilling path during endodontic access. It was possible to verify its applicability in the location of calcified root canals, dens invaginatus, removal of fiberglass posts and MTA, and in paraendodontic surgeries. It has advantages such as greater preservation of tooth structure, shorter working time and prevention of iatrogenesis, and can be performed by less experienced professionals and without the use of a surgical microscope. Limiting factors such as interocclusal space, straight-line access and root thickness have been reported. Among the disadvantages are the additional cost, planning time, number of visits, exposure to radiation by CBCT and the use of special drills. Conclusion: It was concluded that guided endodontics is predictable, accurate and provides greater longevity of the treated tooth. However, for the technique to continue to progress, investment in further research is essential.
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References
ALI, A.; ARSLAN, H. Effectiveness of the static-guided endodontic technique for accessing the root canal through MTA and its effect on fracture strength. Clin Oral Investig, v. 25, n. 4, p. 1989–1995, Apr. 2021. DOI: https://doi.org/10.1007/s00784-020-03507-x
ANDERSON, J.; WEALLEANS, J.; RAY, J. Endodontic applications of 3D printing. Int Endod J, v. 51, n. 9, p. 1005–1018, Sept. 2018. DOI: https://doi.org/10.1111/iej.12917
BUCHGREITZ, J. et al. Guided access cavity preparation using cone-beam computed tomography and optical surface scans - an ex vivo study. Int Endod J, v. 49, n.8, p. 790-5, Aug. 2016. DOI: https://doi.org/10.1111/iej.12516
BUCHGREITZ, J.; BUCHGREITZ, M.; BJØRNDAL, L. Guided Endodontics Modified for Treating Molars by Using an Intracoronal Guide Technique. J Endod, v. 45, n. 6, p. 818–823, June. 2019. DOI: https://doi.org/10.1016/j.joen.2019.03.010
CARVALHO, TS; LUSSI, A. Age-related morphological, histological and functional changes in teeth. J Oral Rehabil, v. 44, n. 4, p. 291-298, Apr. 2017. DOI: https://doi.org/10.1111/joor.12474
CASADEI, B. et al. Access to original canal trajectory after deviation and perforation with guided endodontic assistance. Aust Endod J, v. 46, n. 1, p. 101–106, Apr. 2020. DOI: https://doi.org/10.1111/aej.12360
CHO, C.; JO, H. J.; HA, J.-H. Fiber-reinforced composite post removal using guided endodontics: a case report. Restor Dent Endod, v. 46, n. 4, p. 1–8, Nov. 2021. DOI: https://doi.org/10.5395/rde.2021.46.e50
CONNERT, T. et al. Microguided endodontics: Accuracy of a miniaturized technique for apically extended access cavity preparation in anterior teeth. J Endod, v. 43, n. 5, p. 787-790, May. 2017. DOI: https://doi.org/10.1016/j.joen.2016.12.016
CONNERT, T. et al. Microguided Endodontics: a method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided technique. Int Endod J, v. 51, n. 2, p. 247-255, Feb. 2018. DOI: https://doi.org/10.1111/iej.12809
CONNERT, T. et al. Guided endodontics versus conventional access cavity preparation: a comparative study on substance loss using 3-dimensional-printed teeth. J Endod, v. 45, n. 3, p. 327-331, mar. 2019. DOI: https://doi.org/10.1016/j.joen.2018.11.006
CONNERT, T. et al. Real-time guided endodontics with a miniaturized dynamic navigation system versus conventional freehand endodontic access cavity preparation: Substance loss and procedure time. J Endod, v. 47, n. 10, p. 1651–1656, Oct. 2021. DOI: https://doi.org/10.1016/j.joen.2021.07.012
CONNERT, T.; WEIGER, R.; KRASTL, G. Present status and future directions – Guided endodontics. Int Endod J, v. 55, n. 4, p. 995-1002, Jan. 2022. DOI: https://doi.org/10.1111/iej.13687
DIANAT, O. et al. Guided endodontic access in a maxillary molar using a dynamic navigation system. J Endod, v. 47, n. 4, p. 658-662, Apr. 2021. DOI: https://doi.org/10.1016/j.joen.2020.09.019
FONSECA TAVARES, W. L. et al. Guided endodontic access of calcified anterior teeth. J Endod, v. 44, n. 7, p. 1195-1199, July 2018. DOI: https://doi.org/10.1016/j.joen.2018.04.014
FONSECA TAVARES, W. L. et al. Limitations and management of static-guided endodontics failure. J Endod, v. 48, n. 2, p. 273–279, Feb. 2022. DOI: https://doi.org/10.1016/j.joen.2021.11.004
FU, W. et al. Endodontic microsurgery of posterior teeth with the assistance of dynamic navigation technology: A report of three cases. J Endod, v. 48, n. 7, p. 943-950, July 2022. DOI: https://doi.org/10.1016/j.joen.2022.03.010
GONÇALVES W. F. et al. Guided endodontics in root canals with complex access: two cases reports. Braz. Dent. J., v. 36, n. 6, p. 115-123, Nov-Dec. 2021. DOI: https://doi.org/10.1590/0103-6440202104537
KOCH, G. K. et al. Guided Access Cavity Preparation Using Cost-Effective 3D Printers. J Endod, v. 48, n. 7, p. 909-913, July 2022. DOI: https://doi.org/10.1016/j.joen.2022.04.005
KRASTL, G. et al. Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology. Dent Traumatol, v. 32, n. 3, p. 240-246, June 2016. DOI: https://doi.org/10.1111/edt.12235
KRUG, R. et al. Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report. Head Face Med, v. 16, n. 1, p. 27, Nov. 2020. DOI: https://doi.org/10.1186/s13005-020-00240-4
LAI, P. T. et al. Computer-aided design-guided endodontic microsurgery for a mandibular molar with hypercementosis. J Formos Med Assoc, v. 118, n. 10, p. 1471–1472, Oct. 2019. DOI: https://doi.org/10.1016/j.jfma.2019.06.007
LARA-MENDES, S. T. O. et al. Guided endodontic access in maxillary molars using cone-beam computed tomography and computer-aided design/computer-aided manufacturing system: A case report. J Endod, v. 44, n. 5, p. 875-879, May 2018. DOI: https://doi.org/10.1016/j.joen.2018.02.009
LARA-MENDES, S. T. O. et al. A new approach for minimally invasive access to severely calcified anterior teeth using the guided endodontics technique. J Endod, v. 44, n. 10, p. 1578–1582, Oct. 2018. DOI: https://doi.org/10.1016/j.joen.2018.07.006
LEONTIEV, W. et al. Suitability of magnetic resonance imaging for guided endodontics: Proof of principle. J Endod, v. 47, n. 6, p. 954–960, June 2021. DOI: https://doi.org/10.1016/j.joen.2021.03.011
LLAQUET PUJOL M. et al. Guided endodontics for managing severely calcified canals. J Endod, v. 47, n. 2, p. 315-321, Feb. 2021. DOI: https://doi.org/10.1016/j.joen.2020.11.026
LOUREIRO, M. A. Z. et al. Guided endodontics: The impact of new technologies on complex case solution. Aust Endod J, v. 47, n. 3, p. 664–671, Feb. 2021. DOI: https://doi.org/10.1111/aej.12498
MAIA, L. M. et al. Case reports in maxillary posterior teeth by guided endodontic access. J Endod, v. 45, n. 2, p. 214–218, Feb. 2019. DOI: https://doi.org/10.1016/j.joen.2018.11.008
MAIA, L. M. et al. Endodontic guide for the conservative removal of a fiber-reinforced composite resin post. J Prosthet Dent, v. 128, n. 1, p. 4-7, July 2022. DOI: https://doi.org/10.1016/j.prosdent.2020.11.044
MORENO-RABIÉ, C. et al. Clinical applications, accuracy and limitations of guided endodontics: a systematic review. Int Endod J, v. 53, n. 2, p. 214–231, Feb. 2020. DOI: https://doi.org/10.1111/iej.13216
NAYAK A. et al. Computer-aided design-based guided endodontic: A novel approach for root canal access cavity preparation. Proc Inst Mech Eng H, v. 232, n. 8, p. 787-795, Aug 2018. DOI: https://doi.org/10.1177/0954411918788104
PEREZ C. et al. Microguided endodontics: Accuracy evaluation for access through intraroot fibre-post. Aust Endod J, v. 47, n. 3, p. 592-598, Dec. 2021. DOI: https://doi.org/10.1111/aej.12524
SANTIAGO, M. C. et al. Guided endodontic treatment in a region of limited mouth opening: a case report of mandibular molar mesial root canals with dystrophic calcification. BMC Oral Health, v. 22, n. 1, p. 1–11, Feb. 2022. DOI: https://doi.org/10.1186/s12903-022-02067-8
TODD, R. et al. Template-guided endodontic access. J Am Dent Assoc, v. 152, n. 1, p. 65–70, Jan. 2021. DOI: https://doi.org/10.1016/j.adaj.2020.07.025
TORRES, A. et al. Microguided Endodontics: a case report of a maxillary lateral incisor with pulp canal obliteration and apical periodontitis. Int Endod J, v. 52, n. 4, p. 540–549, Apr. 2019. DOI: https://doi.org/10.1111/iej.13031
TORRES, A. et al. Guided endodontics: Use of a Seeveless Guide System on an upper premolar with pulp canal obliteration and apical periodontitis. J Endod, v. 47, n. 1, p. 133-139, Jan. 2021. DOI: https://doi.org/10.1016/j.joen.2020.09.016
VAN DER MEER WJ. et al. 3D Computer aided treatment planning in endodontics. J Dent, v. 45, p. 67-72, Feb. 2016. DOI: https://doi.org/10.1016/j.jdent.2015.11.007
VINAGRE, A. et al. Management of pulp canal obliteration—systematic review of case reports. Medicina (kaunas), v. 57, n. 11, p. 1237, Nov. 2021. DOI: https://doi.org/10.3390/medicina57111237
ZEHNDER MS. et al. Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location. Int Endod J, v.49, n. 10, p. 966-972, Oct. 2016. DOI: https://doi.org/10.1111/iej.12544
ZUBIZARRETA-MACHO, Á. et al. Endodontic re-treatment and restorative treatment of a dens invaginatus type II through new technologies. J Clin Exp Dent, v. 11, n. 6, p. 570–576, June 2019. DOI: https://doi.org/10.4317/jced.55840
ZUBIZARRETA-MACHO, Á. et al. Effect of computer-aided navigation techniques on the accuracy of endodontic access cavities: A systematic review and meta-analysis. Biology, v. 10, n. 3, p. 1–11, Mar. 2021. DOI: https://doi.org/10.3390/biology10030212
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