Instrument retrieval using ultrasonics and minimally invasive guided endodontics using AReneto^® system: a case report

Instrument separation during root canal treatment presents a significant challenge, particularly in the apical third of the canal. This case report highlights the use of ultrasonics for retrieving a separated instrument and demonstrates the application of augmented reality using the AReneto^® system to perform a minimally invasive guided access opening through the dental prosthesis, allowing root canal treatment to be performed without the need for prosthesis removal.

A 61-year-old Indian male presented with pain in the lower left front teeth, following root canal treatment on tooth 33. Clinical examination revealed tenderness on percussion, and radiographs showed a separated instrument in the apical third of tooth 33, along with periapical radiolucency involving teeth 33 and 32. Ultrasonics under magnification were used to successfully retrieve the separated instrument from tooth 33, followed by sectional obturation and anatomic post placement. Subsequently, guided access for root canal treatment was performed on tooth 32 using the AReneto^® system without removing the existing porcelain-fused-to-metal bridge. The procedure was guided using augmented reality to assist the access opening through the bridge. At the 6-month follow-up, the patient was asymptomatic, and radiographs indicated healing.

The use of ultrasonics combined with magnification enabled effective instrument retrieval, while the AReneto^® system facilitated a minimally invasive approach to root canal treatment through an existing prosthesis. This case demonstrates the potential of augmented reality technology to enhance precision and preserve tooth structure in endodontics. Further advancements in augmented reality-guided systems will likely expand their clinical utility across various dental treatments.