Pulp Calcification and External Reabsortion Resulting from Dental Trauma in Childhood, Associated with the Applicability of Guided Endodontic Treatment – Endoguide: Case Report

Introduction: Pulp canal calcification is characterized by the deposition of calcified tissue along the canal walls. As a result, the root canal can become completely obliterated, making endodontic treatment and its chemical- mechanical preparation difficult and contributing to accidents and complications. The objective of this case report is to understand that digital dentistry has added value in several dental situations. Endoguide provides safety, precision, efficiency, minimizes operative time, and reduces the chances of root canal deviation and damage to surrounding tissues. Methodology: The literature review was carried out through a bibliographic survey on guided endodontic treatment in obliterated canals. The clinical case reported here was treated at the dentistry clinic of the Euro-American University Center (UNIEURO). Case report: A 23-year-old female patient with a history of trauma in the anterior region of the maxilla at least 10 years ago reported that there was no intervention at the time of the incident and detailed how the trauma occurred. The patient presented to the UNIEURO dental clinic complaining of darkening of the crown of tooth 21. Radiographically, significant external resorption was observed and the clinical examination showed marked vestibularization. When performing sensitivity tests on tooth 21, negative responses were obtained. The lower teeth were also the focus of observation for analysis of possible impairment during the trauma that occurred. It was observed that all were vital, except for tooth 21, thus confirming the diagnostic hypothesis of Pulp Calcification. The patient was referred to the radiology clinic with a request for an imaging exam: Computed Tomography on a Prexion device; known for allowing a more detailed view of the root canal system and the periapical region. Subsequently, intraoral scanning was performed at the Voxells clinic, where the Stereo lithography (STL) file was acquired and combined with images in the DICOM (Digital Imaging and Communications in Medicine) file. Subsequently, Trion was responsible for developing the 3D model and printing it to guide the endodontic access surgery in the appropriate position and angle. Conclusion: The guided endodontic technique is safe, effective and faster. It increases predictability, minimizes the risk of deviations and perforations, and promotes greater comfort for the patient and dentist. It is important for the professional to be familiar with this cutting- edge technology and its benefits in the dental world.