Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11425-11436
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11425
Three-dimensional inlay-guided endodontics applied in variant root canals: A case report and review of literature
Yin-Qiu Yan, Hui-Li Wang, Yu Liu, Tai-Jing Zheng, Ya-Ping Tang, Rui Liu
Yin-Qiu Yan, Tai-Jing Zheng, Ya-Ping Tang, Rui Liu, Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), Chongqing 400042, China
Yin-Qiu Yan, College of Stomatology, Chongqing Medical University, Chongqing 400016, China
Hui-Li Wang, Department of Nursing, Xi’an International University, Xi’an 710077, Shaanxi Province, China
Yu Liu, Chuang Neng Technology Co., Ltd., Chongqing 400042, China
Author contributions: Yan YQ and Liu R wrote the manuscript and treated the patient; Liu Y designed the three-dimensional plate; Wang HL, Zheng TJ, and Tang YP provided advice on possible treatment strategies and gave valuable comments regarding important intellectual content of the manuscript.
Supported by the Youth Development Project of Army Military Medical University, No. 2018XQN014; the Clinical Innovation Project of Army Military Medical University, No. 2019XLC2014; and the Science and Technology Foundation of Chongqing, China, No. cstc2014jcyjA10092.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Rui Liu, PhD, Associate Professor, Department of Stomatology, Daping Hospital, The Third Military Medical University (Army Medical University), No. 10 Changjiang Road, Yuzhong District, Chongqing 400042, China. dentistlr@163.com
Received: June 26, 2021
Peer-review started: June 26, 2021
First decision: September 1, 2021
Revised: September 6, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 26, 2021
Abstract
BACKGROUND

Root canal retreatment is common after root canal therapy in clinical situations. Especially, completing the retreatment of variant root canals can be challenging. This is particularly true for the molars located at the end of the dental arch. However, advancements in digital dental diagnosis and treatment techniques can solve these problems. Here, we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel “inlay-guided endodontics” technique based on improved computer-generated programs.

CASE SUMMARY

A 63-year-old man complained of a defect in the maxillary left second molar. The tooth, diagnosed with post-treatment endodontic disease, was initially treated by conventional methods, which were ineffective. Our “inlay-guided endodontics” technique was subsequently adopted, with the establishment of a precise integrated three-dimensional (3D) plate model of cone-beam computed tomography data and a digital impression of the dentition. An optimal root canal approach was generated for the “virtual file” in the 3D model. The plate data were imported into a 3D printer and printed. With the help of the guide plate, the file was accurately placed into the cervical third of the distal root canal. The root canal and prosthodontic treatments successfully proceeded subsequently.

CONCLUSION

Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.

Keywords: Inlay-guided endodontics, Three-dimensional printed templates, Root canal retreatment, Variant root canal, Root canal therapy, Case report

Core Tip: Operating the maxillary second molar is challenging due to the limited clinical space. “Guided orthodontics” has not been used to identify variant root canals of molars. We developed “inlay-guided endodontics” to improve on “guided endodontics”. Our guide plates may enable individualized, minimally invasive root canal treatment.