Comparative Evaluation of Static-guided versus Freehand Endodontic Access in Single-rooted Permanent Teeth with Pulp Canal Calcification: A Randomized Clinical Trial

Abstract

Introduction

The present study aimed to compare the use of conventional freehand access cavity preparation with the static-guided (SG) endodontic technique in terms of its ability to locate and negotiate root canals, iatrogenic errors (perforations), and the amount of tooth structure loss while treating single-rooted traumatized teeth with pulp canal calcifications.

Methods

This randomized clinical trial was registered in the Clinical Trial Registry of India (https://ctri.nic.in, CTRI/2024/01/061580). A total of 30 patients with traumatized teeth exhibiting calcified root canals were included in the study. The patients were randomly divided into 2 groups as follows: SG endodontic technique and conventional freehand technique. Following the completion of the treatments, the cases were evaluated as either successful (canal located) or failed (perforation or canal not located). In addition, the amount of removed tissue was calculated on the postoperative radiographs using ImageJ software (National Institutes of Health, Bethesda, MD). Chi-square and Mann–Whitney U tests were performed to analyze the data (P = .05).

Results

In the SG endodontic group, the root canals were located in all teeth, while in the conventional freehand approach, 13% of cases reported failure to locate the root canals. The tooth sturucture loss was significantly lower in the SG approach compared to the conventional freehand approach (P < .05).

Conclusion

The conventional freehand technique caused three times more tooth structure loss compared to the SG endodontic approach. There were no failed cases in the SG endodontic technique group, and all root canals were successfully located.