Multidisciplinary Rehabilitation of Discoloured and Calcified Maxillary Incisors using MTA, EndoGuide-Assisted Canal Negotiation, and Aesthetic Restoration: A Case Report

Managing calcified root canals and discoloured anterior teeth remains a clinical challenge due to diagnostic complexity and the risk of procedural complications. This case report presents a multidisciplinary approach for the rehabilitation of maxillary incisors affected by pulp canal obliteration, apical pathology and aesthetic concerns. A 28-year-old male patient reported with discolouration of the maxillary right central incisor, while the adjacent lateral incisor exhibited complete canal calcification. Tooth 11 was treated through surgical endodontic intervention involving apicectomy and retrograde Mineral Trioxide Aggregate (MTA) obturation, supplemented with Platelet-Rich Fibrin (PRF) membrane and collagen plug placement to promote periapical healing, followed by non-vital bleaching. Tooth 12 was successfully managed using static guided endodontics, enabling safe negotiation of the obliterated canal and subsequent obturation. The combined use of Cone-Beam Computed Tomography (CBCT)-guided planning, surgical intervention, and aesthetic rehabilitation resulted in favourable functional and aesthetic outcomes at the six-month follow-up. This report underscores the clinical value of guided endodontics and a multidisciplinary treatment strategy in managing complex anterior endodontic cases.