3D Printing and Guided Endodontics: The Future of Precision Access Cavity Design

The evolution of endodontic practice is witnessing a paradigm shift toward precision and minimally invasive interventions. Guided endodontics, empowered by advancements in three-dimensional (3D) printing and digital imaging, has transformed the way access cavities are planned and executed. Conventional access approaches can sometimes lead to excessive removal of dentin, prompting interest in more conservative techniques. With the integration of cone-beam computed tomography (CBCT), intraoral scanning, and computer-aided design/computer-aided manufacturing (CAD/CAM), clinicians can now visualize internal root anatomy preoperatively and fabricate patient-specific guides that direct access burs with high accuracy. This study explores the technological foundation, clinical applications, and limitations of 3D-printed guided endodontic systems, emphasizing their role in preserving critical tooth structure and improving treatment predictability. It also discusses the future potential of artificial intelligence (AI) and real-time navigation systems in enhancing clinical precision and accessibility.