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Updated: Nov 2, 2025
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Dynamic Navigation in Endodontics: Guided Access Cavity Preparation by Means of a Miniaturized Navigation System
Published on: May 5, 2022
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Computer-Controlled CO2 Laser Ablation System for Cone-beam Computed Tomography and Digital Image Guided Endodontic
Jacob C Simon1, Jason W Kwok2, Frank Vinculado1
1Department of Preventive and Restorative Dental Sciences, University of California San Francisco, San Francisco, California.
Journal of Endodontics
|June 13, 2021
Summary
Laser-assisted endodontic access using cone-beam computed tomography (CBCT) and augmented reality offers a precise, minimally invasive approach. This in vitro study successfully demonstrated accurate tooth access with reduced hard tissue removal compared to traditional methods.
Area of Science:
- Dental Technology
- Minimally Invasive Dentistry
- Endodontics
Background:
- Ideal endodontic access requires unobstructed pulp chamber entry and canal orifice visualization while preserving tooth structure.
- Minimally invasive endodontics aims to conserve maximum tooth structure during dental procedures.
- Traditional access methods can lead to significant removal of healthy tooth tissue.
Purpose of the Study:
- To implement laser technology for accurate and predictable endodontic access.
- To evaluate the principles of minimally invasive endodontics using laser ablation.
- To assess the efficacy of computer-aided design and augmented reality in endodontic access preparation.
Main Methods:
- A computer-controlled 9.3-μm CO2 laser ablation system was utilized.
- Cone-beam computed tomographic (CBCT) data was integrated with digital images for augmented reality guidance.
- Laser access was performed in vitro on 20 sound posterior teeth using various access designs.
Main Results:
- All 20 teeth were successfully accessed without iatrogenic errors.
- Laser ablation demonstrated significantly reduced hard tissue removal across all tested access designs compared to traditional methods.
- Specific volumetric measurements showed traditional access removed 39.41 mm3, while conservative and ultraconservative methods removed significantly less.
Conclusions:
- Digital image guidance combined with CBCT data provides a viable method for dynamic navigation in endodontic access.
- Modern computer-controlled laser systems are effective for precise and efficient dental hard tissue cutting.
- Laser-assisted endodontic access aligns with minimally invasive principles, reducing tissue removal.
