Accuracy and dentin conservation of guided endodontic access versus conventional access in simulated calcified...

Pulp canal obliteration presents a significant challenge during conventional endodontic access, often resulting in procedural errors and excessive dentin removal. Therefore, it is of interest to evaluate the accuracy and dentin conservation of guided endodontic access compared with conventional freehand access in simulated calcified canals using micro-computed tomography. Forty extracted mandibular premolars with induced canal obliteration were randomly allocated to guided (n = 20) and conventional (n = 20) access groups and angular deviation, linear deviation at the apex, access cavity volume, remaining dentin thickness and procedure time were assessed. Guided access demonstrated significantly lower angular and linear deviations, reduced cavity volume and greater preservation of dentin thickness compared with the conventional approach (p < 0.001). Guided endodontic access is a more accurate and minimally invasive technique for managing calcified canals and may reduce iatrogenic complications while improving long-term treatment outcomes.