Microguided Endodontics: Accuracy of a Miniaturized Technique for Apically Extended Access Cavity Preparation in Anterior Teeth

Introduction: The aim of this study was to assess the accuracy of guided endodontics in mandibular anterior teeth by using miniaturized instruments. This technique is designed to treat teeth with pulp canal calcifications and narrow roots by using a printed template that guides a bur to the calcified root canal. Methods: Sixty sound mandibular anterior teeth were used in 10 mandibular models. Preoperative surface and cone beam computed tomography scans were matched by using the coDiagnostix software. Virtual planning was performed for the access cavities, and templates were used for guidance. The templates were produced by a three-dimensional printer. Two operators performed the access cavities. A postoperative cone-beam computed tomography scan was superimposed on the virtual plan, and the deviation was measured in 3 dimensions and angles. Descriptive statistical analyses were performed, and 95% confidence intervals were calculated for both operators and each measured aspect. Results: The deviations between the planned and prepared-access cavities were low, with means ranging from 0.12 to 0.13 mm for different aspects at the base of the bur and 0.12 to 0.34 mm at the tip of the bur. The mean of angle deviation was 1.59. A considerable overlap of the 95% confidence intervals indicated no significant difference between the operators. The mean treatment time, including planning and preparation, was approximately 10 minutes per tooth. Conclusions: Microguided endodontics provides an accurate, fast, and operator-independent technique for the preparation of apically extended access cavities in teeth with narrow roots such as mandibular incisors.