Robot-assisted Minimally Invasive Management of a Calcified Mandibular Lateral Incisor: A Case Report

Abstract

INTRODUCTION AND AIMS: Calcified root canals in mandibular anterior teeth present significant therapeutic challenges due to their narrow anatomy and minimal tolerance for procedural errors. This case report demonstrates the successful integration of robot-assisted navigation with an ultra-fine bur to address these challenges. METHODS: A 44-year-old male presented with symptomatic chronic apical periodontitis and pulp calcification in a mandibular lateral incisor, 20 years after orthodontic treatment. An autonomous robotic system achieved real-time bur tracking within a dynamic 3D coordinate system through combined Cone-beam computed tomography and intraoral scan data. Ultra-fine instrumentation (bur tip: 0.28 mm) preserved more pericervical dentin during access, while subsequent canal preparation eliminated stress-concentrating ledges through continuous taper formation. RESULTS: A postoperative periapical radiograph confirmed precise access without iatrogenic errors. A 6-month follow-up demonstrated asymptomatic and periapical healing. CONCLUSION AND CLINICAL RELEVANCE: This approach reduced operator dependence through automated path execution and established a replicable framework for balancing canal negotiability with structural preservation. Future studies must validate 5-year outcomes and explore cost-reduction strategies for broader clinical adoption.