Guided Endodontic Treatment of an Upper Lateral Incisor: A Successful Outcome in the Presence of Procedural Errors-A Case Report.

Performing endodontic treatment on calcified root canals is highly challenging and time-intensive. Even with the assistance of a dental operating microscope, the probability of iatrogenic errors is high. The aim of this report is to present successful endodontic treatments for severely calcified maxillary anterior teeth using a 3D endodontic sleeveless guide, providing a basis for upcoming validation through more comprehensive research. A 25-year-old male patient was referred to the dental office with a chief complaint of pain and swelling of his Tooth 2.2 who explained a previous history of trauma. On clinical examination, periapical swelling was observed, and the tooth demonstrated tenderness to percussion and palpation in the periapical region. Radiographic findings included a severely obliterated pulp chamber and a calcified root canal with periapical radiolucency. In order to perform the root canal treatment with an endodontic guide, an optical impression was carried out using an intraoral scanner. Data from the impression and CBCT files were aligned and sent to the dental laboratory. A virtual copy of a drill was superimposed onto the scans in an optimal position that provided access to the root system, using Exoplan software. A digital model was created and exported as an STL file and transferred to a 3D printer to produce a template. Despite several limitations, successful root canal treatment was conducted. At the 6-month follow-up visit, the patient reported no symptoms, and periapical radiography showed a diminished periapical lesion. Static endodontic guidance provides an opportunity to have more reliable and predictable outcomes in treating complex root systems, even in the presence of minor issues such as transportation and file separation.