Dynamic Navigation System-assisted extraction of fully impacted mandibular second molars under conscious sedation: a...

The extraction of fully impacted mandibular teeth often involves risk of damage to adjacent anatomical structures, and patients often experience anxiety. Traditional pre-operative imaging modalities lack the ability for real-time precise localisation of teeth during surgery. A dynamic navigation system (DNS) employs optical principles to achieve real-time tracking of both the patient and surgical instruments. This is the first case report describing the use of a DNS for the extraction of an impacted second molar. Additionally, we conducted a systematic literature review to summarise the applications of DNSs in dentoalveolar surgery. In the case report, a 19-year-old male presented with unerupted 37. Pre-operative image data revealed that tooth 37 was deeply vertically impacted close to the mandibular canal, with a suspicious cystic lesion in the pericoronal region. Considering its anatomical relationship with adjacent structures, and the patient's pre-operative anxiety, the surgical method ultimately chosen was extraction under conscious sedation via DNS. The surgery successfully achieved the goal of precise, minimally invasive and patient comfort-oriented treatment, with excellent post-operative healing and no complications. This case report and literature review suggest that DNS is characterised by high precision, synchronous positioning capability, and intra-operative visualisation. It may have specific applications in dentoalveolar surgery.