Computer-Aided Static Navigation for Endodontic Management of Pulp Canal Obliteration in A Maxillary Lateral Incisor: A Case Report

Introduction: Pulp canal obliteration (PCO) presents a considerable challenge during endodontic treatment because progressive narrowing of the root canal space makes conventional canal localization difficult. Static-guided endodontics combines cone-beam computed tomography (CBCT), optical surface scanning, and computer-aided planning to facilitate a predetermined access pathway.Case Presentation: A 35-year-old male patient presented with discoloration of a maxillary anterior tooth (tooth 22) for 3 years. The patient had undergone access cavity preparation approximately 4 years previously, during which canal negotiation was unsuccessful and treatment was discontinued. Clinical and radiographic examination revealed partial pulp canal obliteration and a periapical radiolucency with a periapical index (PAI) score of 4. The diagnosis was previously initiated therapy with asymptomatic apical periodontitis. Static-guided endodontic access was planned by integrating CBCT data in Digital Imaging and Communications in Medicine (DICOM) format with optical surface scan data in Standard Tessellation Language (STL) format. A patient-specific guide was fabricated, and guided access was performed using a 0.8-mm Munce Discovery Bur. Following successful canal localization, conventional root canal treatment was completed using rotary instrumentation, sodium hypochlorite and EDTA irrigation, and lateral compaction obturation. The tooth was subsequently restored with a definitive full-coverage restoration.Outcome: The patient was asymptomatic at the 3-month review. At the 1-year follow-up, the tooth remained asymptomatic, with complete radiographic healing of the periapical tissues.Conclusion: Static-guided endodontics may facilitate canal localization in selected cases of PCO, particularly when conventional canal negotiation has been unsuccessful. This case demonstrates the clinical application of a digitally planned access pathway followed by conventional endodontic treatment.