Guided Endodontics in Calcified Canals: Literature Review

Endodontic treatment controls the root canal microbiota by shaping, disinfecting and filling the canals to promote periapical healing. The calcification process is linked to pulp alterations, usually caused by an inflammatory process due to caries, loss of tooth surface, trauma or pulp exposure. This study aimed to emphasize the influence of computed tomography-guided endodontics on the accuracy and efficacy of endodontic treatments compared to conventional techniques. Articles were selected from PubMed, SCIELO and BVS databases using the descriptors "endodontics OR root canal treatment AND dental calcification AND pulp cavity AND cone beam computed tomography". The study included articles published from 2013 to 2023. After analyzing the inclusion and exclusion criteria, 20 articles were selected. Endodontic treatment of calcified teeth is challenging and can result in failures in root canal instrumentation and disinfection. Also, it leads to complications such as perforation and weakening of the tooth structure due to excessive wear. Thus, minimally invasive endodontics is gaining prominence in contemporary endodontics. New techniques, such as guided endodontics, are emerging and have helped to reduce the risk of root perforation.