Innovative Endodontic Management of Pulp Canal Obliteration in Mandibular Incisors Using a Static Navigation System:...

The present case report aims to describe the successful management of pulp canal obliteration (PCO) in mandibular incisors using static-guided endodontics. A healthy 74-year-old man was referred by a prosthodontist for root canal treatment on teeth #31, #32, and #41. Periapical radiographs revealed the presence of periapical lesions as well as PCOs in teeth #31 and #41. After cone-beam computed tomography (CBCT) evaluation, guided endodontics was selected as the treatment approach. The intraoral scan of the lower jaw and CBCT datasets were aligned and processed through image processing software to design and create a 3D-printed guide. A virtual drill was superimposed on the scans to ensure proper access to the identified root canals. Finally, the virtually designed guide was printed using a 3D printer and accurately positioned on the teeth. The access cavities were prepared using a Munce Discovery bur. After detecting the canals, the working length was determined. Root canal preparation was performed using rotary files up to F2, followed by obturation with gutta-percha and a bioceramic sealer. After a six-month follow-up, the teeth remained completely asymptomatic and functional, and the periapical radiograph showed a normal periodontal ligament space, demonstrating the effectiveness of the treatment. These results indicate that static-guided endodontics can be an effective and predictable approach for managing PCO in mandibular incisors with some consideration. Furthermore, these results highlight the clinical implications of this approach, particularly in elderly patients or teeth with severe obliterations.