MANUSCRIPT GUIDED ENDODONTIC ACCESS CAVITY OF CALCIFIED TEETH. A SYSTEMATIC REVIEW
Abstract
The field of endodontics is both lucrative and demanding. Even the most skilled clinicians may find it difficult to negotiate, clean, and shape canals, especially if calcifications have obstructed them. It can take a long time and be difficult to get around these obstacles; occasionally, it is also impossible. Although they have had varying degrees of success, various strategies have been devised to help with this issue. This is a crucial issue since the outcome of endodontic therapy depends on the removal or reduction of bacterial impacts on periapical tissues. The aim of this systematic review was to compare the conventional freehand and guided endodontic approaches to access cavity preparation and canal localization seen in calcified pulp canals.
Our approach was to review relevant articles that specifically evaluated canal access in cases of obliteration due to calcification. The search was conducted from January 2016 to May 2023, utilizing the following keywords and combinations: (guided endodontics) AND (access cavity) AND (pulp calcification) on PubMed and Google Scholar search engines. A total of 21 studies were included in the review after careful sorting and the exclusion of articles that did not meet the inclusion criteria. A PRISMA flowchart was used as the critical appraisal tool.
Results from this review have revealed the comparative advantage of guided technique over conventional freehand technique, with successes recorded in terms of lesser tooth tissue loss, reduced incidence of iatrogenic errors, and a faster clinical approach to navigating calcified canals. A significant limitation of the guided approach is the relative cost when compared to the conventional freehand approach due to the necessary usage of intraoral scanning and a cone beam CT. However, with the aid of guided endodontics, calcified root canals can be located and navigated more quickly and with substantially less tooth loss. There is, however, little literaturethat compares the quantitative success rates of the conventional freehand approach and the guided approach. More studies in this area will give a broader view and extensively explain the successes and limitations of each method.
