Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11425
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
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.
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.
Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.
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.