A Cadaver-based Comparison of Sleeve-guided Implant-drill and Dynamic Navigation Osteotomy and Root-end Resections

Abstract

The purpose of this study was to compare the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation methods for osteotomy and root-end resection (RER). Fifty root specimens from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (n=25). Cone-beam computed tomography (CBCT) scans were conducted before and after the surgery. Osteotomy and RER were virtually planned in the preoperative CBCT scan. Endodontic microsurgery was executed with the guidance of 3D-printed surgical guides in FG sCAEMS and a 3D-dynamic navigation system in dCAEMS. Analysis involved calculating 2D and 3D deviations as well as angular deflection. Additionally, osteotomy volume, resected root length, and recording osteotomy and RER time were measured. The number of procedural errors were recorded. FG sCAEMS demonstrated comparable accuracy to dCAEMS, with no significant difference in 2D and 3D deviation values or angular deflection (P > .05). FG sCAEMS led to reduced osteotomy and RER times (P < .05). However, FG sCAEMS exhibited a higher incidence of incomplete RERs compared to dCAEMS. Osteotomy volume, RER angle, and resected root length were similar in both groups (P > .05). Overall, both FG sCAEMS and dCAEMS proved to be viable options for performing osteotomy and RER. Within the constraints of this study based on cadaver samples, FG sCAEMS demonstrated comparable accuracy to dCAEMS and both methods were efficient for performing osteotomy and RER.