Guided Endodontics versus Conventional Access Cavity Preparation: A Comparative Study on Substance Loss Using...

Area of Science:

• Dentistry
• Endodontics
• Dental Technology

Background:

• Calcified root canals pose a significant challenge in endodontic treatment.
• Conventional access cavity preparation can be time-consuming and lead to excessive tooth structure removal.

Purpose of the Study:

• To compare the effectiveness of guided endodontics versus the conventional technique for preparing access cavities in teeth with calcified root canals.
• To evaluate canal detection rates, tooth substance loss, and treatment duration for both methods.

Main Methods:

• Utilized 3D-printed jaw models with simulated calcified root canals.
• Fabricated splints for guided access preparations based on 3D scans and CBCT data.
• Prepared access cavities using both conventional and guided techniques under simulated clinical conditions, with subsequent volumetric assessment via CBCT.

Main Results:

• Guided endodontics achieved a 91.7% canal location success rate, compared to 41.7% with the conventional technique.
• Mean substance loss was significantly lower with guided endodontics (9.8 mm³) versus conventional (49.9 mm³).
• Treatment duration was shorter with guided endodontics (11.3 minutes) compared to conventional (21.8 minutes).

Conclusions:

• Guided endodontics offers a more predictable and faster method for locating and navigating calcified root canals.
• This technique results in substantially less tooth substance loss.
• Operator experience did not impact the success rate of the guided approach.