Guided endodontics: foundations, clinical applications, and limitations in contemporary endodontic practice

Abstract

Objective: To review the scientific evidence on the technological foundations, clinical applications, advantages, and limitations of guided endodontics in contemporary practice. Literature review: Guided endodontics integrates cone-beam computed tomography, intraoral scanning, virtual planning, and guidance systems to increase the predictability of endodontic access. Its main indication remains the localization of calcified root canals, although applications in the removal of intracanal posts, retreatment, and endodontic surgery have also been described. Laboratory studies indicate greater accuracy and preservation of dental structure compared with conventional approaches. However, clinical evidence remains limited, and greater technical accuracy does not always translate into superior long-term outcomes. High costs, the need for training, anatomical limitations, and dependence on digital infrastructure also restrict its applicability. Final considerations: Guided endodontics has the potential to improve safety and predictability in complex cases; however, its routine incorporation depends on more robust clinical evidence, greater technological accessibility, and standardized protocols.