Comparative Assessment of Access Cavity Preparation in Calcified Teeth between Conventional and Guided Endodontics: An in-vitro Study

Purpose To evaluate the accuracy of access cavity preparation in calcified teeth between conventional and guided endodontics. Methodology 28 extracted human upper centrals were selected. The samples were separated into two groups of fourteen samples each based on the access cavity preparation technique [Group I – Conventional Access Opening and Group II - Guided Access Preparation]. Pre-operative CBCT scans were taken, and then conventional endodontic treatment was done. Preoperative CBCT scan and samples were matched using an intra-oral scanner; a 3D printer prepared 3D printed templates. Then, guided access preparation was done using guided templates, and post-operative CBCT scans were taken to calculate the shift from planned to prepared access cavities. Results In the conventional endodontic group, there was no statistically significant difference (p = 0.171) in the mean base of the bur (angle) deviation between pre-op CBCT and actual values. All the parameters showed statistically significant differences (p < 0.05) between pre-op CBCT and actual values. In the guided endodontic group, there was a statistically significant difference (p = 0.028) in the mean tip of the bur (apical–coronal) deviation between pre-op CBCT and actual values. There was no statistically significant difference (p > 0.05) between the pre-op CBCT values and the actual results for the remaining parameters. Conclusion Guided endodontics allowed an accurate access cavity preparation in calcific metamorphosis teeth compared to the conventional endodontic procedure. Following guided endodontic preparation, all root canals were accessible.