Management of pulp canal obliteration using a combination of dynamic navigation system and dental operating microscope: Case reports with 2-year follow-up

The conventional management of teeth with pulp canal obliteration (PCO) carries several risks such as deviation, perforation, and excess dentin removal. Dynamic navigation system (DNS) has recently emerged as a useful tool to improve the accuracy and efficiency of canal localization in teeth with PCO. This article discusses two cases of partial PCO in maxillary anterior teeth with pulp necrosis and symptomatic apical periodontitis which required endodontic intervention. The initial drill path was prepared using DNS. However, there was a deviation in the mid-root region in both cases, and hence with the aid of the dental operating microscope, troughing with ultrasonics was done for the successful negotiation of the apical one-third of the root canals. Both patients were asymptomatic at the 2-year follow-up, and radiographs showed healing of the periapical lesions.