A Case of Calcific Metamorphosis in Trauma-affected Maxillary Anteriors: A Guided Approach for Success

Pulp Canal Obliteration (PCO) is a frequent sequela of dental trauma that is defined by the radiographic presentation of augmented dentin deposition, which results in partial or total reduction of the pulp chamber and canal system. While usually asymptomatic, PCO may complicate subsequent endodontic treatment, especially when traditional techniques are used to navigate the calcified canals. Conventional approaches are dependent on the expertise of the clinician and are often associated with risks like perforation and unnecessary removal of tooth structure. Static Guided Endodontics (GE) is a new approach to treating such difficult cases. This method combines Cone-Beam Computed Tomography (CBCT) imaging with Computer-Aided Design (CAD) and 3D printing to create a custom-made guide that guides the access preparation with greater accuracy. By offering a pre-determined path to the canal, static GE reduces the risk of iatrogenic mistakes and enhances overall treatment results. This case report describes the treatment of a 19-year-old male with a history of dental trauma who presented with pain, swelling and discolouration of 11 and tenderness with respect to 21. Clinical and radiographic findings showed calcified canals and apical changes, leading to a diagnosis of pulp necrosis with PCO. GE treatment was planned. The report outlines the diagnostic procedure, planning, and implementation of the treatment.