Dynamic Navigated Computer-Guided Incision and Corticotomy: Description of a Novel Technique and a Case Report

This report describes an innovative dynamic computer-guided piezocision technique that integrates preoperative digital planning with real-time intraoperative navigation to accelerate orthodontic treatment while minimizing complications. A 24-year-old female patient who requested short-term orthodontic treatment underwent a minimally invasive, flapless corticotomy using a dynamic system. Preoperative optical scanning and cone-beam computed tomography were performed for comprehensive three-dimensional surgical planning. Intraoperatively, reference trackers were fixed and calibration was performed, enabling precise guidance. A conventional scalpel, adapted with a drill-tag, was employed to execute fully guided soft tissue incisions, and a piezoelectric cutting insert was calibrated for corticotomy cuts. The dynamic navigation system provided continuous real-time feedback on instrument position during the surgical procedure, guiding the surgeon regarding location, depth, and angulation, while ensuring optimal irrigation to reduce thermal risks. The fully guided dynamic piezocision technique enabled the execution of corticotomies following the planned cuts without surgical complications such as damage to dental roots or periodontal tissues. The dynamic approach allowed intraoperative adjustments and improved irrigation, reducing the risk of thermal injury. Fully guided dynamic piezocision may enhance surgical accuracy and safety compared to traditional methods by combining preoperative digital planning with real-time dynamic navigation.