Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report
Background
To report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.
Case presentation
A 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth.
Conclusions
In patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
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On 17 Nov, 2020
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Received 22 Aug, 2020
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Received 24 Jul, 2020
Invitations sent on 21 Jul, 2020
On 01 Jul, 2020
On 30 Jun, 2020
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Guided endodontic treatment of multiple teeth with dentin dysplasia: a case report
On 17 Nov, 2020
On 21 Oct, 2020
Received 21 Oct, 2020
Received 19 Oct, 2020
On 05 Oct, 2020
On 02 Oct, 2020
On 21 Sep, 2020
Invitations sent on 21 Sep, 2020
On 21 Sep, 2020
Received 21 Sep, 2020
On 20 Sep, 2020
On 20 Sep, 2020
Posted 19 Jun, 2020
On 28 Aug, 2020
Received 24 Aug, 2020
On 22 Aug, 2020
Received 22 Aug, 2020
On 27 Jul, 2020
On 24 Jul, 2020
Received 24 Jul, 2020
Invitations sent on 21 Jul, 2020
On 01 Jul, 2020
On 30 Jun, 2020
On 19 Jun, 2020
On 18 Jun, 2020
Background
To report the outcome of guided endodontic treatment (GET) of a case of dentin dysplasia (DD) with pulp canal calcification (PCC) and apical periodontitis (AP) based on the use of a 3D-printed template designed by merging cone-beam computed tomography (CBCT) and surface scan data.
Case presentation
A 12-year old female with radicular dentin dysplasia type I (DD-1) presented for endodontic treatment. Radiography revealed PCC in all teeth and apical radiolucency in seven teeth (15, 12, 26, 36, 32, 31 and 46). Tooth 36 had the most acute symptoms and was thus treated first by conventional access cavity preparation and root canal detection. Despite meticulous technique, the distal and mesiolingual canals were perforated. The perforations were immediately repaired with mineral trioxide aggregate, and the decision was made to switch to guided endodontic treatment for the remaining 6 teeth. CBCT and intraoral surface scans were acquired and matched using coDiagnostix planning software (Dental Wings Inc.), the respective drill positions for root canal location were determined, and templates were virtually designed and 3D-printed. The template was positioned on the respective tooth, and a customized drill was used to penetrate the calcified part of the root canal and perform minimally invasive access cavity preparation up to the apical region. All root canals were rapidly and successfully located with the templates. At 1-year follow-up, clear signs of apical healing were present in all treated teeth.
Conclusions
In patients with dentin dysplasia, conventional endodontic therapy is challenging. GET considerably facilitates the root canal treatment of teeth affected by dentin dysplasia.
Figure 1
Figure 2
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Figure 4
Figure 5
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Figure 7