Technique sensitivity and iatrogenic complications of static guided endodontics in a calcified maxillary incisor: a case report

Static guided endodontics is advocated for conservative access in calcified canals; however, its success is highly technique-sensitive and dependent on guide design and bur selection. An 18-year-old male was referred for continuation of endodontic treatment in a discoloured maxillary central incisor without pain or swelling. Clinical and radiographic evaluation revealed a previously attempted endodontic treatment in a calcified canal associated with asymptomatic apical periodontitis and cervical perforation. Static guided endodontics was planned for conservative canal localization; however, intraoperative deviation of the drill path resulted in re-perforation due to guide- and bur-related limitations. The canal was subsequently located conventionally, obturated, and the perforation repaired with mineral trioxide aggregate. Follow-up demonstrated satisfactory healing. This case highlights the technique sensitivity and potential iatrogenic risks of static guided endodontics.