Retrospective analysis of guided access technique in calcified canals using cone beam tomography and digital scanning

The endodontic treatment of teeth presenting with calcified pulp is associated with significant technical difficulties. Aim: To evaluate the success rate of the guided access technique for root canals using cone beam computed tomography (CBCT) between 2019 and 2021. Material and Method: The study selected cases of anterior and posterior teeth with severe pulp calcification, totaling 100 teeth including 59 incisors, 2 canines, 8 premolars, and 31 molars. CBCT scans were performed for all patients, and a virtual burr path was planned on a computer screen to guide the drill to the beginning of the root canal. The virtual drill path was delineated based on axial and cross-sectional tomographic data, and a template was fabricated using Computer Numerical Control (CNC) technology. Success was determined by reaching the canal lumen without deviation from the original path. Results: The success rate of the guided access technique was 99.1%, with calcification diagnosed in 48.7% of cases. Clinical history revealed deep restoration and necrosis in 34.8% of cases, and trauma in 34.8%. In 65.2% of cases, an attempt was made before referral for guided access. Conclusion: The guided access technique demonstrated high success rates, particularly when appropriately indicated. Clinical relevance: Guided access technique provides a reliable option for managing calcified root canals, thereby improving treatment outcomes.