Comparative evaluation of accuracy and efficiency of two techniques of guided root-end resection using a dynamic navigation system – An in vitro study

Abstract Introduction: Dynamic navigation technology is revolutionizing endodontic microsurgery by enabling real-time surgical guidance and improved procedural accuracy. The incorporation of trephine burs and multiple drill techniques has further enhanced the precision and predictability of root-end resections. Within this context, the present study aimed to compare the accuracy and efficiency of two dynamic navigation-assisted root-end resection techniques. Materials and Methods: Thirty standardized three-dimensionally printed maxillary central incisors were fabricated and randomly allocated into three groups ( n = 10 each): freehand with trephine (FH-T), dynamic navigation system (DNS)-assisted trephine, and DNS -assisted sequential drills. Preoperative cone-beam computed tomography (CBCT) scans were obtained, and root-end resection was performed following the respective group protocols. Postoperative CBCT scans were then acquired to evaluate accuracy parameters, including entry, apex, and angular deviations, using EvaluNav ® software. The operation time for each procedure was recorded to assess efficiency. Data were analyzed using one-way analysis of variance with Tukey’s post hoc test ( P ≤ 0.05). Results: The DNS-assisted trephine approach demonstrated a significantly lower mean entry deviation, apex deviation, and angular deviation, in addition to the shortest operation time compared to the FH-T approach. Conclusion: The DNS-assisted trephine approach demonstrated superior accuracy in entry, apex, and angular deviations, along with the shortest operation time, indicating enhanced efficiency compared to the freehand trephine approach.