Guided Endodontic Access in Maxillary Molars Using Cone-beam Computed Tomography and Computer-aided Design/Computer-aided Manufacturing System: A Case Report.

Autor:	Lara-Mendes STO; Department of Endodontics, Faculty of Dentistry, Universidade de Itaúna, Itaúna, Minas Gerais, Brazil. Electronic address: soniamendes@hotmail.com., Barbosa CFM; Department of Endodontics, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Campinas, Campinas, São Paulo, Brazil., Santa-Rosa CC; Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil., Machado VC; Department of Radiology, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of endodontics [J Endod] 2018 May; Vol. 44 (5), pp. 875-879. Date of Electronic Publication: 2018 Mar 20.
DOI:	10.1016/j.joen.2018.02.009
Abstrakt:	The aim of this study was to describe a guided endodontic technique that facilitates access to root canals of molars presenting with pulp calcifications. A 61-year-old woman presented to our service with pain in the upper left molar region. The second and third left molars showed signs of apical periodontitis confirmed by the cone-beam computed tomographic (CBCT) scans brought to us by the patient at the initial appointment. Conventional endodontic treatment was discontinued given the difficulty in locating the root canals. Intraoral scanning and the CBCT scans were used to plan the access to the calcified canals by means of implant planning software. Guides were fabricated through rapid prototyping and allowed for the correct orientation of a cylindrical drill used to provide access through the calcifications. Second to that, the root canals were prepared with reciprocating endodontic instruments and rested for 2 weeks with intracanal medication. Subsequently, canals were packed with gutta-percha cones using the hydraulic compression technique. Permanent restorations of the access cavities were performed. By comparing the tomographic images, the authors observed a drastic reduction of the periapical lesions as well as the absence of pain symptoms after 3 months. This condition was maintained at the 1-year follow-up. The guided endodontic technique in maxillary molars was shown to be a fast, safe, and predictable therapy and can be regarded as an excellent option for the location of calcified root canals, avoiding failures in complex cases. (Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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