Dynamic Navigation System - Guided Extraction Of Impacted Second Molar

The extraction of fully mandibular impacted teeth is often at risk of damage to vital anatomical structures, and patients often experience anxiety. Traditional preoperative imaging modalities lack the capability for real-time precise localization of teeth during surgery. Dynamic navigation system (DNS) employs optical principles to achieve real-time tracking of both the patient and surgical instruments. The use of DNS for the removal of an impacted second molar will be elucidated in this case report. A 19-year-old male patient came to our hospital for malocclusion. The oral and maxillofacial regions presented a basically symmetrical appearance. Tooth 37 did not erupt. Preoperative image data display that tooth 37 is vertically deeply 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 preoperative anxiety, the surgical method was finally chosen for extraction under conscious sedation using DNS (Dental Implant Navigation Equipment, Suzhou Digital health Care Co., Ltd.). This is the first report of a case where a left mandibular fully impacted second molar was successfully extracted under conscious sedation using DNS and with the application of STA painless anesthesia injection and ultrasonic bone scalpel. This provided the patient with a painless, minimally invasive, comfortable, and precise treatment outcome, and no postoperative complications occurred. DNS is characterized by high precision, synchronous positioning capability, and intraoperative visualization. It has specific application value in dentoalveolar surgery.