The State of the Art in Guided Endodontics and a Case Report
"Endodontics; Root Canal Therapy; Retreatment; Microsurgery; Surgery, Computer-Assisted; Computer-Aided Design; Printing, Three-Dimensional; Robotic; Dental Pulp Calcification”
“The success of endodontic treatments has shown a trend of stagnation over time, with little variation in outcomes, both in non-surgical and surgical cases. Complex challenges, such as the intricate anatomy of root canals and obstructions within the canals, contribute to persistent failures due to difficulty accessing necrotic contents and microbial contamination. Conventional endodontic treatment demands time and skill from the professional, as well as causing greater stress to the patient, wear on dental structures, and less precision compared to guided techniques. These limitations negatively impact dental resilience and can compromise the long-term prognosis of the tooth, as well as future success rates of endodontic treatments. Advanced technologies have demonstrated satisfactory results in complex treatments, such as computer-guided techniques. The aim of this doctoral thesis is to explore guided endodontics in four distinct chapters. The first chapter conducts a comprehensive literature review, entitled "The State of the Art of Guided Endodontics," addressing recent advances in guided techniques in endodontics and their technological implications, including the role of artificial intelligence and robotics in endodontic treatment. Emerging techniques are analyzed, providing a broad view of the current landscape, their clinical applications, and potential benefits. The second chapter presents an innovative case study, "Guided Endodontic Treatment in a Restricted Oral Access Region," describing the treatment of a mandibular molar with dystrophic calcification in the mesial root canals. CAD-CAM strategies and the creation of endodontic guides allowed for a safer and quicker approach. Chapters 3 and 4 discuss the thesis conclusions and their clinical relevance in overcoming challenges in complex treatments, also presenting the Press Release. By bringing together these chapters, this thesis offers a comprehensive analysis of the current state of guided endodontics and its potential to advance clinical practice, contributing to enhancing understanding of this area in its early stages of development.”