Targeted Endodontic Access Preparation: Comparing Grid-guided and Freehand Cone-beam Computed Tomography Techniques

Area of Science:

• Endodontics
• Dental Technology
• Surgical Accuracy

Background:

• Endodontic access is challenging, especially with calcified or missed canals.
• Accurate access is crucial for successful root canal treatment and retreatment.

Purpose of the Study:

• To compare the accuracy of prefabricated grid-guided versus freehand endodontic access techniques.
• To evaluate accuracy using cone-beam computed tomography (CBCT) measurements.

Main Methods:

• Twenty extracted maxillary molars were used, with simulated calcified pulp chambers and cemented crowns.
• Teeth were randomly assigned to freehand or grid-guided groups.
• CBCT scans were used to plan and evaluate drill path deviations and procedural times.

Main Results:

• The grid-guided technique showed significantly less deviation (0.3 mm) from the planned access compared to the freehand technique (0.95 mm).
• The grid-guided approach required significantly more procedural time (417 seconds) than the freehand method.

Conclusions:

• The grid-guided technique is an accurate method for achieving targeted endodontic access.
• This technique is a viable option for accessing difficult-to-reach canal orifices.
• Further clinical studies are recommended to assess its application.