Efficacy of 3D Printed Endodontic Guide in Conservative Access Preparation—An In vitro Study

Background: Navigation in dentistry is a significant advancement in digital dentistry, also known as guided dentistry. Originally introduced in neurosurgery, navigation technology enables precise, minimally invasive procedures and has since been adapted to various medical fields, including dentistry. Objective: This study aimed to evaluate the efficacy of 3D-printed endodontic guides in preserving pericervical dentin (PCD) and enhancing fracture resistance during conservative access preparation. The research compared the outcomes of guided endodontic to traditional endodontic preparation. Methods: The study included 28 noncalcified extracted teeth: 14 teeth prepared using the guided technique and 14 using the traditional method. Data were collected from pre- and post-cone beam computed tomography scans to assess PCD preservation, and fracture resistance was measured using a universal testing machine. Guided approach involved creating a customized drill path using Romexis software (Planmeca Romexis ® , Helsinki, Finland), followed by 3D printing of guides using Sprintray Pro95 printer. Results: The results showed a clear advantage of the guided technique in preserving PCD, consistently preserved more dentin across all tooth types and surfaces, especially in molars and premolars, with significantly higher fracture resistance. PCD preservation was correlated with improved mechanical resilience, with guided access demonstrating superior structural integrity. Conclusion: Endodontic guides offer a promising, conservative approach for preserving tooth structure and reducing the risk of fracture, thus enhancing the long-term prognosis of endodontically treated teeth.