From the desk of the editor: Guided endodontics – A paradigm step forward into the future

Shishir Singh

doi:10.4103/jcd.jcd_291_23

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EDITORIAL

Year : 2023 | Volume : 26 | Issue : 3 | Page : 247-248

From the desk of the editor: Guided endodontics – A paradigm step forward into the future

Shishir Singh
Department of Conservative Dentistry and Endodontics, Terna Dental College, Navi Mumbai, Maharashtra, India

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Date of Submission	04-May-2023
Date of Acceptance	05-May-2023
Date of Web Publication	16-May-2023

How to cite this article:
Singh S. From the desk of the editor: Guided endodontics – A paradigm step forward into the future. J Conserv Dent 2023;26:247-8

How to cite this URL:
Singh S. From the desk of the editor: Guided endodontics – A paradigm step forward into the future. J Conserv Dent [serial online] 2023 [cited 2023 Jun 11];26:247-8. Available from: https://www.jcd.org.in/text.asp?2023/26/3/247/376905

As research and scientific developments are happening in various fields, our specialty is on the go too. Techniques used for guided surgeries in medicine have now evolved for dentistry in implantology and, most importantly, for endodontics. This progress will only help us endodontists come out with more predictable treatment outcomes yielding maximum success and better results.

A review by Kulinkovych-Levchuk et al.^[1] brings out the vast number of research articles that have been published so far. Locating the canal in pulp obliteration and severe calcification cases is one of the great challenges for the endodontist. Using magnification and cone-beam computed tomography (CBCT) although helpful the use of three-dimensional (3D)-printed guides and splints is a good option too.^[2] Surgical endodontics comes with a host of challenges, such as retrograde fillings, where guided endodontics can play an important role.

Guided endodontics can be divided into:

Static-guided endodontics
Dynamic-guided endodontics.

While both techniques need the use of CBCT, the static technique uses a scanned image or models of the patient to be scanned later, while the dynamic technique encompasses the CBCT as well as markers together with a dynamic navigation system.^[3]

Connert et al. have explained in detail the workflow for both these techniques with a clear understanding of their varied use as well as their present and future status.^[4] Su et al.^[5] in their research confirmed the accuracy of 3D printing in access cavity preparations, while Lio et al.^[6] have shown its use in apicoectomy and microsurgery. While the time taken is much less, the intraoperative and postoperative complications are much less and procedures are extremely predictable with excellent accuracy and, most importantly, prevent iatrogenic complications.^[7]

While there are a lot of advantages to guided endodontics, the operator must be aware that this procedure comes has its limitations leading to inaccuracies.^[8] As aptly described by Moreno-Rabié et al.,^[9] the level of evidence being low more outcome studies is needed to substantiate the technique.

It is heartening to see that India is also at the forefront when it comes to guided endodontics, where the static and dynamic techniques are being routinely used with some heartening publications.^[10],[11] In conclusion, while this technology looks positive, careful long-term research studies with adequate follow-up are needed to confirm the results and findings.

References

1.	Kulinkovych-Levchuk K, Pecci-Lloret MP, Castelo-Baz P, Pecci-Lloret MR, Oñate-Sánchez RE. Guided endodontics: A literature review. Int J Environ Res Public Health 2022;19:13900.
2.	Zehnder MS, Connert T, Weiger R, Krastl G, Kühl S. Guided endodontics: Accuracy of a novel method for guided access cavity preparation and root canal location. Int Endod J 2016;49:966-72.
3.	Ribeiro D, Reis E, Marques JA, Falacho RI, Palma PJ. Guided endodontics: Static versus dynamic computer-aided techniques-a literature review. J Pers Med 2022;12:1516.
4.	Connert T, Weiger R, Krastl G. Present status and future directions – Guided endodontics. Int Endod J 2022;55 Suppl 4:995-1002.
5.	Su Y, Chen C, Lin C, Lee H, Chen K, Lin Y, et al. Guided endodontics: Accuracy of access cavity preparation and discrimination of angular and linear deviation on canal accessing ability-an ex vivo study. BMC Oral Health 2021;21:606.
6.	Lio F, Mampieri G, Mazzetti V, Leggeri A, Arcuri L. Guided endodontic microsurgery in apicoectomy: A review. J Biol Regul Homeost Agents 2021;35:47-55.
7.	Dąbrowski W, Puchalska W, Ziemlewski A, Ordyniec-Kwaśnica I. Guided endodontics as a personalized tool for complicated clinical cases. Int J Environ Res Public Health 2022;19:9958.
8.	Fonseca Tavares WL, de Oliveira Murta Pedrosa N, Moreira RA, Braga T, de Carvalho Machado V, Ribeiro Sobrinho AP, et al. Limitations and management of static-guided endodontics failure. J Endod 2022;48:273-9.
9.	Moreno-Rabié C, Torres A, Lambrechts P, Jacobs R. Clinical applications, accuracy and limitations of guided endodontics: A systematic review. Int Endod J 2020;53:214-31.
10.	Panithini DB, Sajjan GS, Kinariwala N, Medicharla UD, Varma KM, Kallepalli M. Real-time guided endodontics: A case report of maxillary central incisor with calcific metamorphosis. J Conserv Dent 2023;26:113-7. [Full text]
11.	Sudha A, Krishnan A, Samant PS, Dubey S. Guidodontics: A global positioning system (GPS) to surgical endodontics – A case series. J Conserv Dent 2023;26:241-5. [Full text]