Clinical and radiological outcomes of dynamic navigation in endodontic microsurgery: a prospective study

Clin Oral Investig. 2023 Sep;27(9):5317-5329. doi: 10.1007/s00784-023-05152-6. Epub 2023 Aug 2.

Abstract

Objectives: This study was aimed at evaluating the clinical and radiological outcomes of novel dynamic navigation (DN)-aided endodontic microsurgery (EMS), with an analysis of potential prognostic factors.

Materials and methods: Forty-six teeth from 32 patients who received DN-aided EMS were included. Clinical and radiographic assessments were performed at least 1 year postoperatively. Two calibrated endodontists assessed radiological outcomes according to two-dimensional (2D) periapical radiography (PA) and three-dimensional (3D) cone-beam computed tomography (CBCT) imaging using Rud's and Molven's criteria and modified PENN 3D criteria, respectively. Fisher's exact test was used for statistical analysis of the predisposing factors.

Results: Of the 32 patients with 46 treated teeth, 28 with 40 teeth were available for follow-up. Of the 28 patients, four (five teeth) refused to undergo CBCT and only underwent clinical and PA examinations, and the remaining 24 (35 teeth) underwent clinical, PA, and CBCT examinations. Combined clinical and radiographic data revealed a 95% (38/40) success rate in 2D healing evaluations and a 94.3% (33/35) success rate in 3D healing evaluations. No significant effect was found in sex, age, tooth type, arch type, preoperative lesion volume, preoperative maximum lesion size, presence/absence of crown and post, and the root canal filling state on the outcome of DN-aided EMS.

Conclusions: DN-aided EMS has a favorable prognosis and could be considered an effective and reliable treatment strategy. Further investigations with larger sample sizes are required to confirm these results.

Clinical relevance: DN-aided EMS could be considered an effective and reliable treatment strategy.

Keywords: Dynamic navigation; Endodontic microsurgery; Guided endodontics; Prognosis; Trephine.

MeSH terms

  • Cone-Beam Computed Tomography / methods
  • Humans
  • Microsurgery* / methods
  • Prognosis
  • Prospective Studies
  • Root Canal Therapy / methods
  • Tooth*
  • Treatment Outcome