Related Experiment Video
Updated: Jun 12, 2025
Dynamic Navigation in Endodontics: Guided Access Cavity Preparation by Means of a Miniaturized Navigation System
Published on: May 5, 2022
Real-time Guided Endodontics with a Miniaturized Dynamic Navigation System in Calcified Posterior Teeth: Performance
Lukas Hirt1, Hauke Hildebrand1, Roland Weiger1
1Department of Periodontology, Endodontology and Cariology, University Center for Dental Medicine Basel UZB, University of Basel, Basel, Switzerland.
Introduction:
This study aimed to evaluate the use of a dynamic navigation system for endodontic access cavity preparation (EACP) in posterior teeth.
Methods:
Partially calcified posterior teeth replicas were 3D printed to generate 24 maxillary and mandibular models. Preoperative cone-beam computed tomographic (CBCT) scans were performed for all models. After digital planning of access cavities for dynamic navigation, 2 operators (operator 1 with 7 years of experience and limited to endodontics vs operator 2 with 3 years of experience working as a general dentist) received 12 models with a total of 96 teeth each and performed EACP under simulated clinical conditions. Four weeks after performing EACP using a dynamic navigation system (DNS), EACP was performed using a conventional freehand approach. Postoperative CBCT scans were performed for all models, and substance loss determination was conducted by registering pre- and postoperative CBCT scans.
Results:
The overall substance loss was significantly lower using the DNS compared to conventional freehand approach in molars (29.6 mm3 vs 82.6 mm3; P < .001) and premolars (11.8 mm3 vs 25.3 mm3; P < .001). No significant differences in substance loss between operators 1 and 2 were observed when using a DNS. Operator 1 significantly reduced substance loss only in molars, but not in premolars, when using a DNS.
Conclusions:
Dynamic navigation for EACP is a reliable method in posterior teeth and results in tooth substance preservation. When used by a less experienced general dentist, dynamic navigation can raise the level of performance to that of an experienced endodontist.
