Guided Endodontics—Potential and Limitations

Guided Endodontics has emerged as a digital treatment concept designed to overcome the challenges associated with conventional access cavity preparation in teeth with pulp canal calcification. Calcification of the pulp (also referred to as obliteration or mineralization), often caused by trauma or chronic irritative stimuli, presents a substantial clinical obstacle during endodontic treatment. The advent of computer-assisted technologies such as static and dynamic navigation systems has enabled highly precise and minimally invasive localization of root canal orifices, even in cases of severe calcification. This narrative review explores the clinical indications, technical workflows, and current evidence for both static and dynamic Guided Endodontics, including their limitations and future directions. Numerous in vitro and clinical studies have shown that guided access preparation results in higher precision, reduced dentine loss, and increased success rates compared to freehand techniques, even when performed by less experienced clinicians. While static navigation provides excellent accuracy for straight canals, its application in posterior teeth and curved canals remains limited. Dynamic navigation, in contrast, offers greater intraoperative flexibility but requires significant training and costly equipment. Future developments, including augmented reality integration and MRI-based workflows, may further expand the applicability of Guided Endodontics. However, the current techniques are limited by cost, planning time, and the necessity for advanced imaging. Despite these challenges, Guided Endodontics has the potential to transform the management of calcified canals and represents a significant step forward in minimally invasive endodontics.