Endodontic Microsurgery Using Dynamic Navigation System: A Case Report

Published:September 09, 2019DOI:


      Dynamic navigation systems were introduced to facilitate dental implantology by improving the accuracy of dental implant positioning. Dynamic navigation integrates surgical instrumentation and radiologic images by using an optical positioning device controlled by a dedicated computerized interface. These features could help in reducing the risk of unintentional iatrogenic damage to nearby anatomic structures and perform minimally invasive or flapless surgery, leading to reduced patient postoperative discomfort and improved healing. The present case report showed the use of the Navident dynamic navigation system (ClaroNav, Toronto, Ontario, Canada) by an undergraduate student for bone cavity preparation and root-end resection in the surgical endodontic treatment of a lesion in an upper lateral incisor. The system allowed precise localization of the root and precise apicoectomy with a minimal invasive cavity. The dynamic navigation system allowed the student to precisely direct the bur in 3 dimensions. The osteotomy and root-end resection were easily and quickly performed by the undergraduate student with a minimally invasive approach without iatrogenic errors. The navigation system allowed the operator to precisely perform a minimally invasive osteoctomy and root-end resection during endodontic surgery. The development of dedicated surgical navigation systems for endodontic surgery could facilitate the operator's maneuvers and reduce the risk of iatrogenic errors.

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        • Block M.S.
        • Emery R.W.
        • Cullum D.R.
        • Sheikh A.
        Implant placement is more accurate using dynamic navigation.
        J Oral Maxillofac Surg. 2017; 75: 1377-1386
        • Chen C.K.
        • Yuh D.Y.
        • Huang R.Y.
        • et al.
        Accuracy of implant placement with a navigation system, a laboratory guide, and freehand drilling.
        Int J Oral Maxillofac Implants. 2018; 33: 1213-1218
        • Ewers R.
        • Schicho K.
        • Truppe M.
        • et al.
        Computer-aided navigation in dental implantology: 7 years of clinical experience.
        J Oral Maxillofac Surg. 2004; 62: 329-334
        • Birkfellner W.
        • Solar P.
        • Gahleitner A.
        • et al.
        In-vitro assessment of a registration protocol for image guided implant dentistry.
        Clin Oral Implants Res. 2001; 12: 69-78
        • Siessegger M.
        • Schneider B.T.
        • Mischkowski R.A.
        • et al.
        Use of an image-guided navigation system in dental implant surgery in anatomically complex operation sites.
        J Craniomaxillofac Surg. 2001; 23: 276-281
        • Jorba-García A.
        • Figueiredo R.
        • González-Barnadas A.
        • et al.
        Accuracy and the role of experience in dynamic computer guided dental implant surgery: an in-vitro study.
        Med Oral Patol Oral Cir Bucal. 2019; 24: e76-e83
        • Chong B.S.
        • Dhesi M.
        • Makdissi J.
        Computer-aided dynamic navigation: a novel method for guided endodontics.
        Quintessence Int. 2019; 50: 196-202
        • Shi X.
        • Zhao S.
        • Wang W.
        • et al.
        Novel navigation technique for the endodontic treatment of a molar with pulp canal calcification and apical pathology.
        Aust Endod J. 2018; 44: 66-70
        • van der Meer W.J.
        • Vissink A.
        • Ng Y.L.
        • Gulabivala K.
        3D Computer aided treatment planning in endodontics.
        J Dent. 2016; 45: 67-72
        • Connert T.
        • Zehnder M.S.
        • Amato M.
        • et al.
        Microguided Endodontics: a method to achieve minimally invasive access cavity preparation and root canal location in mandibular incisors using a novel computer-guided technique.
        Int Endod J. 2018; 51: 247-255
        • Gagliani M.M.
        • Gorni F.G.
        • Strohmenger L.
        Periapical resurgery versus periapical surgery: a 5-year longitudinal comparison.
        Int Endod J. 2005; 38: 320-327
        • Eliyas S.
        • Vere J.
        • Ali Z.
        • Harris I.
        Micro-surgical endodontics.
        Br Dent J. 2014; 216: 169-177
        • Rubinstein R.A.
        • Kim S.
        Short-term observation of the results of endodontic surgery with the use of a surgical operation microscope and Super-EBA as root-end filling material.
        J Endod. 1999; 25: 43-48
        • Carr G.B.
        Common errors in periradicular surgery.
        Endod Rep. 1993; 8: 12-18
        • Strbac G.D.
        • Schnappauf A.
        • Giannis K.
        • et al.
        Guided modern endodontic surgery: a novel approach for guided osteotomy and root resection.
        J Endod. 2017; 43: 496-501
        • Giacomino C.M.
        • Ray J.J.
        • Wealleans J.A.
        Targeted endodontic microsurgery: a novel approach to anatomically challenging scenarios using 3-dimensional-printed guides and trephine burs-a report of 3 cases.
        J Endod. 2018; 44: 671-677
        • Ahn S.Y.
        • Kim N.H.
        • Kim S.
        • et al.
        Computer-aided design/computer-aided manufacturing-guided endodontic surgery: guided osteotomy and apex localization in a mandibular molar with a thick buccal bone plate.
        J Endod. 2018; 44: 665-670
        • D'haese J.
        • Van De Velde T.
        • Komiyama A.
        • et al.
        Accuracy and complications using computer-designed stereolithographic surgical guides for oral rehabilitation by means of dental implants: a review of the literature.
        Clin Implant Dent Relat Res. 2012; 14: 321-335
        • Stefanelli L.V.
        • DeGroot B.S.
        • Lipton D.I.
        • Mandelaris G.A.
        Accuracy of a dynamic dental implant navigation system in a private practice.
        Int J Oral Maxillofac Implants. 2019; 34: 205-213