A New Approach for Minimally Invasive Access to Severely Calcified Anterior Teeth Using the Guided Endodontics Technique.

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., Machado VC; Department of Radiology, Faculty of Dentistry, Faculdade São Leopoldo Mandic de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil., Santa-Rosa CC; Department of Restorative Dentistry, Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
Jazyk:	angličtina
Zdroj:	Journal of endodontics [J Endod] 2018 Oct; Vol. 44 (10), pp. 1578-1582. Date of Electronic Publication: 2018 Aug 25.
DOI:	10.1016/j.joen.2018.07.006
Abstrakt:	This article describes an endodontic treatment technique performed through a new minimally invasive approach that leads to no tooth damage at the incisal edge and uses cone-beam computed tomographic (CBCT) imaging and 3-dimensional guides. A 26-year-old patient presented with pain in the anterior region of the maxilla and reported having suffered dental trauma 13 years prior. Radiographic examination exhibited no visible root canal on tooth # 9 with a slight thickening in the apical periodontal ligament space. Pulp sensitivity tests produced no response, whereas the percussion test responded positively. CBCT imaging revealed a visible canal space limited to the apical 2-mm section of the root. Guided endodontic access was planned after intraoral scanning of the tooth surface to be used with the CBCT scan. A virtual model was created with the aid of virtual implant software for the surgical access planning in such a way as not to damage the incisal edge of the tooth. The resulting guides were printed. With guides in position over the rubber dam, a mechanical-chemical preparation was performed in the root as soon as the canal was located. Intracanal medication was left for 14 days, after which the root canal was filled gutta-percha and the access cavity sealed. Follow-up was performed 1 year after completion of the treatment. The patient was asymptomatic with periapical tissue within normal limits. The guided endodontic therapy optimized the treatment, having provided a conservative access with no tooth damage at the incisal edge in a safe and predictable way despite the presence of a severely calcified root canal. (Copyright © 2018 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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