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Recent advancements in endodontic surgery have significantly improved outcomes through enhanced technology, including digital planning, cone-beam computed tomography (CBCT), and operating microscopes. The integration of dynamic navigation systems (DNS) has particularly transformed endodontic microsurgery (EM) by providing real-time guidance and precision. This case report explores the application of DNS in a clinical case of EM involving a mandibular first molar with symptomatic apical periodontitis. A 36-year-old male patient presented with masticatory pain in the lower left quadrant. Radiographic and CBCT evaluations revealed an underfilled mesiolingual canal and a periapical lesion. The surgical procedure utilized DNS for precise osteotomy and apicectomy, guided by the Navident® system and incorporating the cortical window technique. Postoperative care included antibiotic therapy and follow-up appointments, demonstrating successful periapical healing at 21 months. DNS technology significantly enhances precision and conservativeness in EM, allowing for real-time guidance and minimizing iatrogenic risks. The cortical window technique, combined with DNS, facilitates effective root access while preserving bone structure. Despite its advantages, DNS is associated with high costs and a steep learning curve. Future research should focus on evaluating the long-term clinical outcomes of DNS, improving system usability, and exploring its applications in other endodontic procedures. This case report demonstrates the successful use of DNS in conjunction with the cortical window technique for EM, achieving favorable clinical outcomes and promoting accelerated healing. Further studies are needed to validate the broader clinical utility of DNS and to refine its integration into routine practice.
Castillo et al. (Fri,) studied this question.
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