Guided Endodontic Management of Orthodontic-Induced Canal Calcification Using Static Guide: A Case Report

Orthodontic treatment may induce pulpal calcific changes, including pulp stone formation, fibrotic tissue changes, and reduction in pulp volume, which may contribute to canal narrowing and, in some cases, canal obliteration. But with the introduction of guided endodontics, treating calcified tooth has become less complex and also helps in preservation of pericervical dentin when compared with traditional access cavity preparation.

The patient reported pain and sensitivity on both of the maxillary central incisors. Upon examination, the right maxillary central incisor had pulpal exposure requiring immediate treatment, whereas the left maxillary central incisor had a completely obliterated canal and showed no response to thermal and EPT. So, it was decided to treat 21 using static guide. The treatment was completed in two visits for Tooth 21 with very minimal discomfort. To close the midline diastema, a full coverage crown was placed.

This case demonstrates the successful management of obliteration arising from orthodontic tooth movement using a static guide navigation system. The use of a static guide not only helped in preservation of pericervical dentin but also was less time-consuming, hence causing minimal discomfort to the patient.