Calcified Root Canal Management Guided By A Digital Template

This case presents the management of chronic pulpitis with severe calcification in the upper segment of the mesiobuccal (MB) root canal guided by a digital template. A 13-year-old female patient sought dental care for persistent pain in her upper right posterior tooth for over a month. The pain, triggered by thermal stimuli, food impaction, and biting pressure, prompted her visit. The patient had no systemic disease history. Intraoral examination revealed extensive caries on the mesial aspect of tooth 16, with pulp exposure confirmed by probing. Tenderness on probing (positive), along with a small amount of purulent blood-tinged exudate, was noted. Cold testing was dull, percussion caused pain (positive), and no mobility was observed. Radiographs revealed calcification in the upper segment of the MB root canal. CBCT imaging further confirmed a curved root canal with calcification extending approximately 4 mm. Using CBCT DICOM data, DentalNavi, and CAD/CAM intraoral scan data, a guided path was designed. A Yake 3D digital template was fabricated, enabling minimally invasive removal of the calcified tissue and successful clearing of the MB root canal. Root canal treatment was completed under rubber dam isolation. In this case, the digital template-assisted procedure enabled precise removal of the calcified tissue, resulting in successful root canal therapy. Compared to traditional microscopic root canal therapy, this method reduced treatment time, preserved more tooth structure, and provided greater predictability. The use of 3D digital template technology significantly enhances the efficiency and success rate of treating calcified root canals.