Static navigation-assisted treatment of acute periapical periodontitis with pulp canal obliteration: a case report and literature review
10.12016/j.issn.2096-1456.202440378
- Author:
WANG Haiyue
1
;
ZHU Qi
1
;
ZHOU Zhuanyuan
1
;
LIU Wei
1
Author Information
1. Shenzhen Stomatology Hospital (Pingshan) of Southern Medical University
- Publication Type:Journal Article
- Keywords:
pulp canal obliteration / periapical periodontitis / static guided endodontics / locating root canal / minimally invasive access / root-canal therapy / 3D printing / guide plate
- From:
Journal of Prevention and Treatment for Stomatological Diseases
2025;33(2):137-144
- CountryChina
- Language:Chinese
-
Abstract:
Objective :To explore the advantages of static navigation in locating calcified root canal therapy, and to provide reference for clinical diagnosis and treatment of calcified teeth.
Methods:A case of acute periapical periodontitis of anterior teeth with full-length calcification of root canal was reported. A lingual minimally invasive approach was used as a conservative method of controlling the infection of teeth and preserving the incisors through the digital guide plate. The diagnosis and treatment of this type of case were analyzed retrospectively with reference to the literature.
Results:One patient complained that the pain of left anterior teeth was aggravated for 2 days. After examination, he was diagnosed with acute periapical periodontitis of 21 teeth with total root canal calcification. With the assistance of static navigation, the root canal was located after 10 minutes, the calcification was dredged for 15 minutes, and the acute pain symptoms of the patient were relieved that day. After one year of follow-up, there was no discomfort in the teeth, and the range of low-density shadow in the apical film was reduced. After 3 years of follow-up, there was no discomfort in the teeth, and the low-density shadow of the apical root was further reduced by apical film examination. As shown by the results of the literature review, static navigation technology is advantageous because the success rate of dredging calcified root canals is neither associated with the operator’s treatment experience nor the use of microscope and ultrasonic equipment. Regardless of the degree of calcification, this method can significantly reduce the iatrogenic risk, but it is closely related to the accuracy and stability of the guide plate. However, this method is not suitable for calcified teeth with calcification under root canal curvature and limited operating space. Cone-beam computed tomography (CBCT) is recommended to locate calcified root canals, and the imaging quality is an important factor that affects the correct preoperative planning. When performing static navigation endodontic treatment, thermal damage can be reduced by selecting a drill with a small diameter that matches the guide ring and cooling the drill with frozen irrigation solution.
Conclusion:Static navigation-assisted treatment of calcified root canals is accurate and minimally invasive, which reduces clinical treatment time, preserves the lingual approach at the incisal ridge to further ensure the integrity of teeth, and ensures the long-term preservation of affected teeth.
