A Split-Mouth Design Comparison of Guided and Conventional Endodontic Treatments in Calcified Lower Incisors: An In Vivo Pilot Study

Aim: This in vivo pilot study aimed to compare the conventional endodontic technique (CET) to the guided endodontic technique (GET) in lower calcified incisors by focusing on the detection of root canals, amount of dental substance loss, and treatment duration. Methods: Seven patients with two calcified lower incisors with a single canal requiring root canal treatment were selected. For each patient, one incisor underwent CET, and the contralateral incisor underwent GET using a customized sleeve. The intracanal space was volumetrically measured using the indirect post-core technique for comparison. The duration was recorded from the start of the treatment until the root canal orifice was detected. Statistical analysis was conducted using IBM SPSS Statistics (version 25.0), employing the Wilcoxon signed-rank test ((p < 0.05). Results: For the 14 treated teeth, the calcification level was presented at the third middle part of the root canal. All 14 teeth had negotiable canals except one which was treated using the CET. The CET presented a significantly higher intracanal volume (7.8±3.3 mm ³ vs 5.3±1.3 mm ³ , p=0.018) and treatment duration compared to the GET (69.0±57.4 minutes vs 14.1±8.2 minutes; p=0.018). Conclusion: GET offers a more predictable and efficient treatment for calcified lower incisors than CET, with significantly less substance loss and shorter treatment duration. Clinical Relevance: This pilot study highlights the advantages of GET over CET in managing calcified lower incisors. The findings demonstrate that GET significantly improves treatment efficiency, reduces procedural time, and preserves more tooth structure.