Accuracy of Dynamic and Static Navigated Endodontic Microsurgery Using Single Vertical Incision: A Retrospective Study

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BACKGROUND: Dynamic navigation (DN) and static navigation (SN) in endodontic microsurgery (EMS) have been shown to improve the precision of osteotomy and root-end resection (RER). However, the impact of minimal incisions on DN- and SN-guided EMS remains unclear. This study assessed the accuracy of DN and SN in EMS performed via a single vertical incision at the apex (SVIA), and identified technique-specific accuracy predictors. METHODS: A retrospective analysis included 60 teeth treated with SVIA EMS, comprising 30 osteotomies and RERs each in the SN and DN groups. Preoperative variables - sex, age, tooth position, arch type, drilling depth, lesion size, and buccal bone integrity - were recorded. Postoperative cone-beam computed tomography (CBCT) scans were superimposed with preoperative plans to evaluate accuracy. Group comparisons used independent t-tests or Mann-Whitney U tests (α = 0.01); general linear model examined the interaction effects between the technique and preoperative variables on accuracy; multivariate regression (α = 0.017) identified independent predictors within each group. RESULTS: No significant differences in accuracy parameters were observed between DN and SN (P > .01). Interaction effects were nonsignificant (P > .05). Intragroup analysis indicated that for DN, a lesion diameter > 9 mm predicted increased resection angle deviation (RAD) (B = 3.13, P < .017), while for SN, posterior tooth location predicted reduced RAD (B = -5.80, P < .017). CONCLUSIONS: DN and SN exhibited comparable overall accuracy in SVIA EMS. However, DN was less accurate in cases with large lesions, whereas SN achieved higher accuracy in posterior regions. These preliminary findings support the evidence-based selection of guidance techniques according to anatomic specifics in SVIA EMS.

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