Analysis of the accuracy of a dynamic navigation system in endodontic microsurgery: A prospective case series study

Objectives: To evaluate the accuracy of a dynamic navigation system (DNS) for guided osteotomy and root-end resection during endodontic microsurgery (EMS) and assess its prognosis. Methods: Nine patients who met inclusion criteria underwent DNS-guided EMS. Osteotomy and root-end resection were performed with assistance of DNS (DHC-ENDO1, DCARER Medical Technology, Suzhou, China). The preoperative virtually planned path and postoperative cone-beam computed tomography images were superimposed using DNS software. Accuracy was assessed based on deviations in the platform, apex, and angle of the osteotomy, as well as in the length and angle of the root-end resection. Follow-up evaluations were performed after at least a year postoperatively. Results: Among the nine patients (11 teeth with 12 roots), the mean platform, apex, and angular deviation of the osteotomy were 1.05 mm, 1.2 mm, and 6.24 degrees, respectively. The mean length and angle deviation of the root-end resection were 0.46 mm and 4.9 degrees, respectively. Significant differences were observed according to tooth position. The platform and apex deviated significantly less in the posterior than in the anterior teeth (p < .05). No significant differences were observed according to arch type, side, and depth of the surgical path (p > .05). Eight patients were evaluated after at least a year postoperatively; clinical and radiographic evaluation revealed a 90% success rate (9/10 teeth). Conclusions: This study demonstrated high accuracy of DNS in EMS. Furthermore, DNS-guided EMS had a success rate similar to that of freehand EMS over a short-term follow-up. Further study with a larger sample size is necessary. Clinical significance: The present novel DNS technology is a viable method for guided osteotomy and root-end resection in EMS. Clinical trial registration number: ChiCTR2100042312