Journal of Conservative Dentistry
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CASE REPORT
Year : 2023  |  Volume : 26  |  Issue : 1  |  Page : 113-117

Real-time guided endodontics: A case report of maxillary central incisor with calcific metamorphosis


1 Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India
2 Department of Conservative Dentistry, Karnavati University, Gandhinagar, Gujarat, India
3 Department of Conservative Dentistry, Vishnu Dental College and Hospital, Bhimavaram, Andhra Pradesh, India

Correspondence Address:
Dr. Durga Bhavani Panithini
Department of Conservative Dentistry and Endodontics, Vishnu Dental College and Hospital, Bhimavaram - 534 202, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcd.jcd_506_22

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Dental trauma results in various complications and poses an enigma to the practitioner. Calcific metamorphosis is one of the sequelae of trauma. A female patient of 35 years visited the specialty clinic of endodontics for the management of a discolored tooth. Clinically, discolored 21 was observed with no pain on palpation and percussion. The pulp sensibility test revealed a negative response. Radiographic examination revealed pulp canal obliteration with an apical radiolucency of Peri Apical Index (PAI 4). The tooth was diagnosed as necrotic pulp with asymptomatic apical periodontitis. Attempt to negotiate the canal under a Dental Operating Microscope (LABOMED, Los Angeles, CA, USA) and ultrasonics (Satelec, Acteon, France) was futile. Cone-beam computed tomography image revealed a patent canal in the apical third. Using real-time guided endodontics with a dynamic navigation system (Navident, ClaroNav, Toronto, ON, Canada), the protocol of plan, trace, and place was followed, and successful canal negotiation was achieved. After radiographic confirmation, root canal treatment was completed.


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