Efficacy and Precision of Dynamic Navigation System in Locating Calcified Canals: An In-Vitro 3D Analysis

Background Accessing calcified canals can be clinically challenging. This study evaluated the Dynamic Navigation System (DNS) against freehand (FH) techniques in terms of substance loss, accuracy, and procedure duration at different levels of operator experience.Methods 128 3D-printed teeth were accessed by a student and an endodontist using FH and DNS. Evaluations included volumetric substance loss via 3D analysis, canal location success, perforation rates, and procedural time. Statistical significance was assessed for all parameters to compare the efficiency and precision of both methods.Results DNS significantly reduced substance loss compared to FH (p < 0.05). No significant differences existed for canal location (p = 0.111) or perforations (p = 0.858). However, procedural time differences were highly significant (p = 0.00045), showing DNS improved efficiency for the student, while FH yielded a more optimal access geometry.Conclusion DNS minimizes substance loss and reduces procedural time for an inexperienced operator. However, for experienced endodontists, it does not significantly improve location success or perforation avoidance compared to FH techniques.Practical Implications DNS serves as a valuable tool for tooth structure preservation and as a clinical aid for students. However, its benefits for experienced clinicians may be limited in standard scenarios.