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Purpose: To assess the pain, swelling, infection, and alteration in sensation following the flapless placement of zygomatic implants guided by dynamic navigation. Materials and Methods: A randomized controlled trial was conducted on 20 patients. In group 1, the placement of the zygomatic implants was carried out without reflecting a mucoperiosteal flap (flapless). In group 2, a mucoperiosteal flap was raised (flapped). Two zygomatic implants were placed in each patient (one on each side) under local anesthesia, guided by dynamic navigation. Postoperative evaluations included pain (using the visual analogue scale [VAS]), swelling (using standard measurements), maxillary sinus infection, and alteration of sensation (using mechanical stimuli, thermal threshold detection, and a two-point discrimination test). The assessments were carried out at 2 days, 1 week, and then 1, 2, and 3 months postoperatively. Results: In group 1, all implants except for one were successfully osseointegrated. Immediate postoperative pain and swelling were both significantly greater in group 2 (P < .01). No alteration in sensation was detected in any case in the two groups. There were a total of three cases of chronic sinusitis: one in group 1 and two in group 2. Conclusions: The flapless placement of zygomatic implants guided by dynamic navigation and under local anesthesia improves postoperative recovery. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives Materials and Methods Results Conclusions To evaluate and compare the accuracy of task‐autonomous robot‐assisted implant surgery (RAIS) and dynamic computer‐assisted implant surgery (dCAIS) for zygomatic implant placement.Ten atrophic edentulous maxilla models requiring zygomatic implant (ZI) placement were randomly divided into the RAIS and dCAIS groups. Osteotomies and implant placement were performed under the guidance of a task‐autonomous robotic system or dynamic navigation system. A total of 20 ZIs were analyzed. The angular, coronal, lateral coronal, coronal depth, apical, lateral apical, and apical depth deviations were measured and analyzed between the two groups. The primary outcome parameters were the angular deviations between the planned and the placed ZIs. Data was subjected to descriptive and comparative statistical analysis. The significance of inter‐group differences for continuous variables was assessed with Student's two‐sample t‐tests, Welch two‐sample t‐tests, and Mann–Whitney U tests according to the distribution normality and variance homogeneity.ZI placement deviations were compared between the RAIS and dCAIS groups, showing a mean angular deviation of 0.92 ± 0.40° versus 2.03 ± 0.53° (p < 0.001), a mean (±SD) coronal deviation of 0.48 ± 0.25 mm versus 1.29 ± 0.46 mm (p < 0.001), and a mean apical deviation of 0.88 ± 0.28 mm versus 1.96 ± 0.46 mm (p < 0.001).For computer‐guided ZI placement, task‐autonomous RAIS was superior to dCAIS in terms of accuracy. [ABSTRACT FROM AUTHOR]

Objectives: To assess navigation accuracy for complete‐arch implant placement with immediate loading of digitally prefabricated provisional. Materials and Methods: Consecutive edentulous and terminal dentition patients requiring at least one complete‐arch FDP were treated between December 2020 and January 2022. Accuracy was evaluated by superimposing pre‐operative and post‐operative cone beam computed tomography (CBCT), recording linear (mm) and angular (degrees) deviations. T‐tests were performed to investigate the potential effect of the registration algorithm (fiducial‐based vs. fiducial‐free), type of references for the fiducial‐free algorithm (teeth vs. bone screws), site characteristic (healed vs. post‐extractive), implant angulation (axial vs. tilted), type of arch (maxilla vs. mandible) on the accuracy with p‐value <0.05. Results: Twenty‐five patients, 36 complete‐arches, and 161 implants were placed. The overall mean angular deviation was 2.19° (SD 1.26°). The global platform and apex mean deviations were 1.17 mm (SD 0.57 mm), and 1.30 mm (SD 0.62 mm). Meaningful global platform (p = 0.0009) and apical (p = 0.0109) deviations were experienced only between healed and post‐extraction sites. None of the analyzed variables significantly influenced angular deviation. Minor single‐axis deviations were reported for the type of jaw (y‐axis at implant platform and apex), registration algorithm (y‐axis platform and z‐axis deviations), and type of references for the fiducial‐free algorithm. No statistically significant differences were found in relation to implant angulation. Conclusions: Within the study limitations navigation was reliable for complete‐arch implant placement with immediate loading digitally pre‐fabricated FDP. AI‐driven surface anatomy identification and calibration protocol made fiducial‐free registration as accurate as fiducial‐based, teeth and bone screws equal as references. Implant site characteristics were the only statistically significant variable with healed sites reporting higher accuracy compared to post‐extractive. Live‐tracked navigation surgery enhanced operator performance and accuracy regardless of implant angulation and type of jaw. A mean safety room of about 1 mm and 2° should be considered. [ABSTRACT FROM AUTHOR]

Quantitative in vitro research was conducted on the learning process of a dynamic navigation system. This study provides guidance for the promotion and application of dynamic navigation technology in the endodontic apical surgery field. Standardized models were designed and 3D printed to form the approach operation of endodontic apical surgery. 6 clinicians with no experience in dynamic navigation performed the operation. The distance deviation tolerance was set as 0.6 mm, and the angle deviation tolerance was set as 5°. Fifteen mm deep approach operation was completed using dynamic navigation. Each operator performed 10 consecutive exercises on the models. The positioning deviation and operation time of each operator for each practice were recorded. Based on this, the learning curve of the dynamic navigation of every operator was mapped. The learning difficulty of dynamic navigation was evaluated. The learning curves of all operators reached a stable level after the 7th practice, which can ensure that the distance and angle deviations are maintained within the deviation tolerances (0.6 mm, 5°). Operators with no experience in dynamic navigation technology need practice to master dynamic navigation operations. For this navigation system, operators with no operational experience can master dynamic navigation operations after 7 exercises. [ABSTRACT FROM AUTHOR]

Pterygoid implant is a promising solution for patients with a partially or fully edentulous atrophic maxilla. However, whether dynamic navigation system will improve the accuracy of pterygoid implant surgery is still unknown. This study aimed to compare the accuracy of dynamic navigation and free-hand approaches in pterygoid implant placement in completely edentulous maxilla models. Twenty three-dimensional (3D)-printed edentulous maxilla models were assigned to two groups: the dynamic navigation system group and the free-hand group. Two pterygoid implants were planned in the bilateral pterygomaxillary area and then placed in each model. The entry, exit and angle deviations of the pterygoid implants were measured after pre- and post-operative cone-beam CT (CBCT) image fusion. Student's t test and Mann–Whitney U test were used. A P value < 0.05 was considered statistically significant. A total of 40 pterygoid implants were placed in 20 models. The comparison deviation of the dynamic navigation group and the free-hand group showed a mean (±SD) entry deviation of 0.93 ± 0.46 mm vs. 2.28 ± 1.08 mm (P < 0.001), an exit deviation of 1.37 ± 0.52 mm vs. 3.14 ± 1.82 mm (P < 0.001), and an angle deviation of 2.41 ± 1.24° vs. 10.13 ± 4.68° (P < 0.001). There was no significant difference in the accuracy with regard to the side factors between the navigation group and the free-hand group. The dynamic navigation system has higher accuracy for pterygoid implant placement in a complete edentulous maxilla than the free-hand approach. [ABSTRACT FROM AUTHOR]

To assess and compare the precision and predictability of zygomatic implants in atrophic maxilla using conventional and dynamic navigation methods. This study was a randomized controlled clinical trial conducted in patients requiring zygomatic implant placements in the atrophic maxilla. Forty zygomatic implants were placed in systemically healthy individuals. Zygomatic implant placement was done using the freehand technique in the control group, and the test group involved implant placement using a dynamic navigation system, and the entry, apex, and angular deviations were evaluated. The mean deviations at the site of entry (2D) in the navigation system (2.531.42) as compared with the freehand (4.151.29) were statistically significant. The variation in the freehand group was greater than the navigation method at the apex (3D) (P <.05). The navigation method had a higher accuracy in angular deviation than the freehand method (4.02 ± 1.80 and 12.67 ± 2.11). Also, the accuracy was checked on the right and left sides in both the conventional and dynamic groups. The dynamic navigation technology had better predictability in terms of accuracy and precision, and it is the need of the hour for clinicians to master this technology and thereby aid in better prognostic level of implant placements. [ABSTRACT FROM AUTHOR]

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Autonomous navigation for Unmanned Aerial Vehicles (UAVs) has emerged as a critical enabler in various industries, from agriculture, delivery services, and surveillance to search and rescue operations. However, navigating UAVs in dynamic and unknown environments remains a formidable challenge. This paper explores the application of the D* algorithm, a prominent path-planning method rooted in artificial intelligence and widely used in robotics, alongside comparisons with other algorithms, such as A* and RRT*, to augment autonomous navigation capabilities in UAVs' implication for sustainability development. The core problem addressed herein revolves around enhancing UAV navigation efficiency, safety, and adaptability in dynamic environments. The research methodology involves the integration of the D* algorithm into the UAV navigation system, enabling real-time adjustments and path planning that account for dynamic obstacles and evolving terrain conditions. The experimentation phase unfolds in simulated environments designed to mimic real-world scenarios and challenges. Comprehensive data collection, rigorous analysis, and performance evaluations paint a vivid picture of the D* algorithm's efficacy in comparison to other navigation methods, such as A* and RRT*. Key findings indicate that the D* algorithm offers a compelling solution, providing UAVs with efficient, safe, and adaptable navigation capabilities. The results demonstrate a path planning efficiency improvement of 92%, a 5% reduction in collision rates, and an increase in safety margins by 2.3 m. This article addresses certain challenges and contributes by demonstrating the practical effectiveness of the D* algorithm, alongside comparisons with A* and RRT*, in enhancing autonomous UAV navigation and advancing aerial systems. Specifically, this study provides insights into the strengths and limitations of each algorithm, offering valuable guidance for researchers and practitioners in selecting the most suitable path-planning approach for their UAV applications. The implications of this research extend far and wide, with potential applications in industries such as agriculture, surveillance, disaster response, and more for sustainability. [ABSTRACT FROM AUTHOR]

Background/purpose: Pterygoid implant is a promising solution for patients with a partially or fully edentulous atrophic maxilla. However, whether dynamic navigation system will improve the accuracy of pterygoid implant surgery is still unknown. This study aimed to compare the accuracy of dynamic navigation and free-hand approaches in pterygoid implant placement in completely edentulous maxilla models. Materials and methods: Twenty three-dimensional (3D)-printed edentulous maxilla models were assigned to two groups: the dynamic navigation system group and the free-hand group. Two pterygoid implants were planned in the bilateral pterygomaxillary area and then placed in each model. The entry, exit and angle deviations of the pterygoid implants were measured after pre- and post-operative cone-beam CT (CBCT) image fusion. Student's t test and Mann–Whitney U test were used. A P value

Background/purpose: Quantitative in vitro research was conducted on the learning process of a dynamic navigation system. This study provides guidance for the promotion and application of dynamic navigation technology in the endodontic apical surgery field. Materials and methods: Standardized models were designed and 3D printed to form the approach operation of endodontic apical surgery. 6 clinicians with no experience in dynamic navigation performed the operation. The distance deviation tolerance was set as 0.6 mm, and the angle deviation tolerance was set as 5°. Fifteen mm deep approach operation was completed using dynamic navigation. Each operator performed 10 consecutive exercises on the models. The positioning deviation and operation time of each operator for each practice were recorded. Based on this, the learning curve of the dynamic navigation of every operator was mapped. The learning difficulty of dynamic navigation was evaluated. Results: The learning curves of all operators reached a stable level after the 7th practice, which can ensure that the distance and angle deviations are maintained within the deviation tolerances (0.6 mm, 5°). Conclusion: Operators with no experience in dynamic navigation technology need practice to master dynamic navigation operations. For this navigation system, operators with no operational experience can master dynamic navigation operations after 7 exercises.

A range of computer-aided navigation techniques to aid endodontic access cavity preparation have been developed. The aim of this study was to analyze the accuracy of access cavities prepared with the aid of computer-aided static navigation (SN), computer-aided dynamic navigation (DN), and navigation based on augmented reality (AR) compared with a conventional freehand (FH) method in extracted mandibular teeth with calcified root canal systems. Forty single-rooted mandibular teeth were divided into 4 groups, and preoperative cone-beam computed tomographic scans and digital impressions through an intraoral scan were obtained. Access cavities were then prepared using SN (n = 10), DN (n = 10), AR (n = 10), or FH (n = 10), and postoperative cone-beam computed tomographic scans of each tooth were obtained to evaluate deviation of the access cavities between the virtually planned preoperative preparations and the actual postoperative preparations. Analysis of variance followed by Tukey post hoc tests were used to identify significant differences in deviation, with P values below.05 being considered significant. Significant deviations of the access cavities were found coronally between SN and DN (P <.001), SN and AR (P <.001), DN and FH (P =.015), and AR and FH (P =.003) and apically between SN and AR (P =.003) and AR and FH (P =.006). There were significant differences at angular level between SN and DN (P <.001), SN and AR (P <.001), and SN and FH (P =.013). AR was associated with significantly smaller differences in dentin removal and cavity alignment than the SN, DN, and FH methods. Endodontic access cavity preparations using AR technology were more accurate than preparations using other techniques and have the potential to be adopted in clinical practice when canal systems are obliterated. [ABSTRACT FROM AUTHOR]

Objectives: To gauge the relative accuracy of the use of passive and active dynamic navigation systems when placing dental implants, and to determine how registration areas affect the performance of these systems. Materials and Methods: Eighty implants were assigned to be placed into 40 total resin mandible models missing either the left or right first molars using either passive or active dynamic navigation system approaches. U‐shaped tube registration devices were fixed in the edentulous site for 20 models each on the left or right side. Planned and actual implant positions were superimposed to assess procedural accuracy, and parameters including 3D entry deviation, angular deviation, and 3D apex deviation were evaluated with Mann–Whitney U tests and Wilcoxon signed‐rank tests. Results: Respective angular, entry, and apex deviation values of 1.563 ± 0.977°, 0.725 ± 0.268 mm, and 0.808 ± 0.284 mm were calculated for all included implants, with corresponding values of 1.388 ± 1.090°, 0.789 ± 0.285 mm, and 0.846 ± 0.301 mm in the active group and 1.739 ± 0.826°, 0.661 ± 0.236 mm, and 0.769 ± 0.264 mm in the passive group. Only angular deviation differed significantly among groups, and the registration area was not associated with any significant differences among groups. Conclusions: Passive and active dynamic navigation approaches can achieve comparable in vitro accuracy. Registration on one side of the missing single posterior tooth area in the mandible can complete single‐tooth implantation on both sides of the posterior teeth, highlighting the promise of further clinical research focused on this topic. [ABSTRACT FROM AUTHOR]

This study investigated the feasibility of a novel drilling approach that integrates a pilot trephine into dynamic navigation (DN) for guided osteotomy and root-end resection (RER) with unimanual operation in endodontic microsurgery. Two operators with varying levels of DN experience performed guided osteotomy and RER using 2 unimanual drilling methods with DN-aided operation on 3-dimensional printed jaw models. Method 1 (M1) involved drilling with a conventional trephine. Method 2 (M2) involved drilling with a pilot trephine, followed by drilling with a conventional trephine. Accuracy, time, and safety of M1 and M2 were compared. Accuracy measurements included platform deviation (PD), end deviation (ED), angular deviation (AD), resection length deviation (RLD), and resection bevel angle (RBA). Additional parameters included osteotomy and RER time (OT) and bur slippage number (BSN). Statistical analyses were conducted using a 2-sample t -test or Mann–Whitney U test, with the significance level set at.05. The PD, AD, RBA, and BSN in the M2 group were significantly less than in the M1 group (P <.05). For M1, the novice operator (NO) exhibited significantly higher values of PD, ED, OT, and BSN than the experienced operator (EO) (P <.05). For M2, the NO exhibited significantly higher value of ED only (P <.05), and drilling depth >7 mm was significantly associated with a longer OT (P <.05). In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided endodontic microsurgery. [ABSTRACT FROM AUTHOR]

Abstract Background The operation accuracy and efficiency of dynamic navigated endodontic surgery were evaluated through in vitro experiments. This study provides a reference for future clinical application of dynamic navigation systems in endodontic surgery. Materials and methods 3D-printed maxillary anterior teeth were used in the preparation of models for endodontic surgery. Endodontic surgery was performed with and without dynamic navigation by an operator who was proficient in dynamic navigation technology but had no experience in endodontic surgery. Optical scanning data were applied to evaluate the length and angle deviations of root-end resection. And the operation time was recorded. T tests were used to analyze the effect of dynamic navigation technology on the accuracy and duration of endodontic surgery. Results With dynamic navigation, the root-end resection length deviation was 0.46 ± 0.06 mm, the angle deviation was 2.45 ± 0.96°, and the operation time was 187 ± 22.97 s. Without dynamic navigation, the root-end resection length deviation was 1.20 ± 0.92 mm, the angle deviation was 16.20 ± 9.59°, and the operation time was 247 ± 61.47 s. Less deviation was achieved and less operation time was spent with than without dynamic navigation (P

Background: The operation accuracy and efficiency of dynamic navigated endodontic surgery were evaluated through in vitro experiments. This study provides a reference for future clinical application of dynamic navigation systems in endodontic surgery. Materials and methods: 3D-printed maxillary anterior teeth were used in the preparation of models for endodontic surgery. Endodontic surgery was performed with and without dynamic navigation by an operator who was proficient in dynamic navigation technology but had no experience in endodontic surgery. Optical scanning data were applied to evaluate the length and angle deviations of root-end resection. And the operation time was recorded. T tests were used to analyze the effect of dynamic navigation technology on the accuracy and duration of endodontic surgery. Results: With dynamic navigation, the root-end resection length deviation was 0.46 ± 0.06 mm, the angle deviation was 2.45 ± 0.96°, and the operation time was 187 ± 22.97 s. Without dynamic navigation, the root-end resection length deviation was 1.20 ± 0.92 mm, the angle deviation was 16.20 ± 9.59°, and the operation time was 247 ± 61.47 s. Less deviation was achieved and less operation time was spent with than without dynamic navigation (P < 0.01). Conclusion: The application of a dynamic navigation system in endodontic surgery can improve the accuracy and efficiency significantly for operators without surgical experience and reduce the operation time. [ABSTRACT FROM AUTHOR]

Introduction: Nowadays, the training of implant placement has shifted from once entirely instructor–student teaching to the increasing use of computer‐assisted simulation. Based on computerized virtual planning, dynamic navigation has been used for implant placement with higher accuracy than the traditional freehand protocol. However, whether dynamic navigation benefits to the training of dental students in implant placement remains controversial. This study aimed to compare the surgical performance of dental students in implant placement using computer‐assisted dynamic navigation and freehand approaches. Materials and Methods: A total of 20 dental students (6 males, 14 females, age: 25.6 ± 0.5 years) were enrolled in this study. With the traditional freehand approach (training 1) as the control protocol, computer‐assisted dynamic navigation (training 2) was used in the training of dental students in implant placement. For each training, both the operating time (OT) of students and placement accuracy represented by the linear (at the implant platform, Dpl, and apex, Dap) and angular (Dan) deviations between the virtually planned and placed implants were recorded. Statistical comparisons were made between the two training protocols as well as male and female surgeons. Results: OT2 was around twice of OT1 (p <.0001), whereas Dan1 was almost three times of Dan2 (p <.0001). Dap1 and Dpl1 were significantly higher than Dap2 (p =.014) and Dpl2 (p =.033) respectively. Besides, male students showed statistically higher Dpl1 (p =.033) and Dan1 (p =.002) than females. No significant difference was found between male and female students in OT1, OT2, Dpl2, Dap1, Dap2 and Dan2. Conclusions: Within the limitations of this study, the use of computer‐assisted dynamic navigation in the preclinical training could improve the surgical performance of the dental students in implant placement. The combination of dynamic navigation with the traditional preclinical surgical training may benefit to dental students and could be applied in dental education. [ABSTRACT FROM AUTHOR]

Objectives: To assess the efficacy of dynamic computer‐aided surgery (dCAS) in replacing a single missing posterior tooth, we compare outcomes when using registration‐and‐fixation devices positioned anterior or posterior to the surgical site. Registration is performed on either the anterior or opposite posterior teeth. Methods: Forty individuals needing posterior single‐tooth implant placement were randomly assigned to anterior or posterior registration. Nine parameters were analyzed to detect the deviations between planned and actual implant placement, using Mann–Whitney and t‐tests for nonnormally and normally distributed data, respectively. Results: The overall average angular deviation for this study was 2.08 ± 1.12°, with the respective average 3D platform and apex deviations of 0.77 ± 0.32 mm and 0.88 ± 0.32 mm. Angular deviation values for individuals in the anterior and posterior registration groups were 1.58°(IQR: 0.98°–2.38°) and 2.25°(IQR: 1.46°–3.43°), respectively (p =.165), with 3D platform deviations of 0.81 ± 0.29 mm and 0.74 ± 0.36 mm (p =.464), as well as 3D apex deviations of 0.89 ± 0.32 mm and 0.88 ± 0.33 mm (p =.986). No significant variations in absolute buccolingual (platform, p =.659; apex, p =.063), apicocoronal (platform, p =.671; apex, p =.649), or mesiodistal (platform, p =.134; apex, p =.355) deviations were observed at either analyzed levels. Conclusions: Both anterior and posterior registration approaches facilitate accurate dCAS‐mediated implant placement for single missing posterior teeth. The device's placement (posterior‐to or anterior‐to the surgical site) did not affect the clinician's ability to achieve the planned implant location. [ABSTRACT FROM AUTHOR]

Objectives: To assess root canal localization accuracy using a dynamic approach, surgical guides and freehand technique in vitro. Materials and methods: Access cavities were prepared for 4 different 3D printed tooth types by 4 operators (n = 144). Deviations from the planning in angle and bur positioning were compared and operating time as well as tooth substance loss were evaluated (Kruskal-Wallis Test, ANOVA). Operating method, tooth type, and operator effects were analyzed (partial eta-squared statistic). Results: Angle deviation varied significantly between the operating methods (p <.0001): freehand (9.53 ± 6.36°), dynamic (2.82 ± 1.8°) and static navigation (1.12 ± 0.85°). The highest effect size was calculated for operating method (ηP²=0.524), followed by tooth type (0.364), and operator (0.08). Regarding deviation of bur base and tip localization no significant difference was found between the methods. Operating method mainly influenced both parameters (ηP²=0.471, 0.379) with minor effects of tooth type (0.157) and operator. Freehand technique caused most substance loss (p <.001), dynamic navigation least (p <.0001). Operating time was the shortest for freehand followed by static and dynamic navigation. Conclusions: Guided endodontic access may aid in precise root canal localization and save tooth structure. Clinical relevance: Although guided endodontic access preparation may require more time compared to the freehand technique, the guided navigation is more accurate and saves tooth structure. [ABSTRACT FROM AUTHOR]

Objective To discuss the nursing strategy of dynamic navigation technology in the treatment of edentulous implantation with immediate restoration. Methods Totally 42 patients with edentulous jaws treated in First Clinical Division, Peking University School and Hospital of Stomatology from January 2019 to May 2023 were analyzed retrospectively. All the patients were treated with implant-supported immediate restoration of edentulous jaws under dynamic navigation. Nursing care experience was analyzed. Results Through preoperative design and dynamic navigation-assisted surgery, all the patients achieved successful immediate restoration with accurate location of implants and no complication. All the implant were placed at the correct position and achieved good initial stability. Immediate fixation and repair were completed, with a complication rate of 1. 59% at 6 months after surgery. Conclusion Dynamic navigation-assisted edentulous implantation requires nursing staff to get a good knowledge of related theories, appliance installment and software operation. Effective nursing plays important role in the treatment of dynamic navigation-assisted edentulous implantation. (回顾性分析基于以即刻修复为目标的动态导航下无牙颌种植手术的护理配合要点。方法 收集2019年1月—2023年5月收治的在动态导航系统引导下完成无牙颌种植手术伴即刻固定修复的42例患者的临床资料, 分析动态导航技术的应用情况及护理配合特点。结果 42例患者经过术前设计、术中导航均实现精确的种植体植入, 种植体就位率达100%, 并获得良好的初期稳定性, 完成即刻固定修复, 术后6个月并发症发生率为1. 59%。结论 动态导航辅助下的无牙颌种植手术需要护理人员熟练掌握动态导航理论知识、导航器械的安装使用及软件操作等相关技能, 做好充足的术前准备以及默契的术中护理配合, 以确保手术顺利完成。)

Objectives: To compare implant placement accuracy and patient‐centered results between the dynamic computer‐assisted implant surgeries (d‐CAISs) using marker‐based and marker‐free registration methods. Materials and Methods: A double‐armed, single‐blinded randomized controlled trial was conducted, in which 34 patients requiring single implant placement at the esthetic zone were randomly assigned to the marker‐based (n = 17) or marker‐free (n = 17) groups. The marker‐based registration was performed using a splint containing radiopaque markers, while the marker‐free registration used natural teeth. The primary outcome assessed implant positioning accuracy via angular and linear deviations between preoperative and postoperative implant positions in CBCT. Patients were also surveyed about the intraoperative experience and oral health impact profile (OHIP). Results: The global linear deviations at the implant platform (0.82 ± 0.28 and 0.85 ± 0.41 mm) and apex (1.28 ± 0.34 and 0.85 (IQR: 0.64–1.50) mm) for the marker‐based and marker‐free groups respectively showed no significant difference. However, the angular deviation of the marker‐free group (2.77 ± 0.92°) was significantly lower than the marker‐based group (4.28 ± 1.58°). There was no significant difference in the mean postoperative OHIP scores between the two groups (p =.758), with scores of 2.74 ± 1.21 for marker‐based and 2.93 ± 2.18 for marker‐free groups, indicating mild oral health‐related impairment in both. Notably, patients in the marker‐free group showed significantly higher satisfaction (p =.031) with the treatment procedures. Conclusions: D‐CAIS with a marker‐free registration method for single implantation in the anterior maxilla has advantages in improving implant placement accuracy and patients' satisfaction, without generating a significant increase in clinical time and expenses. [ABSTRACT FROM AUTHOR]

Nonsurgical endodontic teeth treatment with severe pulp canal obliteration poses challenges, primarily locating canals. By combining 3-dimensional reconstruction and spatial location registration, the dynamic navigation technique uses an optical tracking system to guide the clinician to drill in real time according to the predesigned path until access to the canal is established. Several in vitro studies and case reports have shown that calcified canal location with dynamic navigation system (DNS) is more accurate and efficient, yet the technique has limitations. In 4 cases with 7 teeth, this work presents manipulation process and clinical outcomes of DNS helping in calcified canal location. We performed handpiece adaptation and elucidated the failure to locate the canals with DNS in 2 teeth, resulting in canal geometry alteration and canal path deviation. Subsequently, the more experienced endodontist located the canals by combining cone-beam computed tomographic imaging and dental operating microscopy. All patients were completely asymptomatic after treatment. At the 1-year follow-up visit, the bone healing of periapical lesions progressed well according to the periapical radiography or cone-beam computed tomographic imaging. These findings indicate that DNS is a promising technique for locating calcified canals; however, it needs to be refined before clinical use. [ABSTRACT FROM AUTHOR]

Computer-assisted dynamic navigation surgery could provide accurate implant placement. However, its low efficiency was always criticized by dental surgeons. The purpose of this study was to evaluate the accuracy and efficiency of a calibration approach with reflective wafers in dynamic navigation for implant placement. Eighty implants were placed in the standardized polyurethane mandibular models under dynamic navigation and divided into 2 groups according to the calibration methods (n = 40). The U-shaped tube (UT) group used a prefabricated U-shaped tube embedded with radiopaque markers. The reflective wafers (RW) group used a fixation with 3 round reflective wafers as markers. Postoperative cone beam computed tomography images were obtained for implants deviation analyses. The calibration time was used to evaluate the efficiency of the 2 methods. Significant differences were found in the trueness and efficiency between the 2 groups (P < 0.05). The 3D deviations at the implant platform and apex were smaller in UT group (0.89 ± 0.28 and 0.79 ± 0.30 mm, respectively) than in the RW group (0.99 ± 0.28 and 0.98 ± 0.30 mm, respectively). The angular deviation was larger in the UT group (2.16 ± 1.12°) than in the RW group (1.53 ± 0.88°). The calibration approach of RW group was more efficient than the UT group (2.05 ± 0.55 and 7.50 ± 0.71 min, respectively). The calibration method of RW improved the efficiency significantly and achieved equivalent trueness with UT for dynamic navigation during implant placement. [ABSTRACT FROM AUTHOR]

Introduction: Dynamic navigation is a fast-growing technology in the field of head and neck surgery, which is now taking its place in oral surgery. The aim of this review was to present and describe all the uses of navigation in oral surgery. Materials and methods: A systematic review was conducted using all clinical trial/cases reports (Embase/PubMed) in which navigation is used during oral surgery, published over the last 5 yr. A total of 32 clinical trial/cases reports were analyzed. Results: Dynamic navigation was used in 7 different indications: implantology (55%), foreign body removal (15%), dental avulsion (12%), bone augmentation (9%), cellulitis (3%), benign tumour (3%), pre-prosthetic surgery (3%). A total of 335 patients were  treated, 631 implants, 8 foreign bodies, 1 benign tumour, 24 dental avulsions, 3 bone augmentations, 1 cellulitis, and 1 pre-prosthetic surgery were found. In implantology, there were 500 standard implants, 75 zygomatic implants, 31 pterygoid implants, 1 short implant and 24 angulated implants. Conclusion: This review showed the recent development of dynamic navigation in oral surgery. The most common indication is dental implantology and few others indications seemed promising. This technique broadened its scope and might become an indispensable tool that can be used in many situations, increasing safety and predictability of a lot of procedure. [ABSTRACT FROM AUTHOR]

This study investigates the feasibility of integrating a piezoelectric device (PIEZO) into a dynamic navigation system (DNS) for bone-window guided surgery. It compares the accuracy and efficiency of PIEZO + DNS to PIEZO + Freehand (FH) procedure for bone-window cutting and root-end resection (RER). Forty-eight mandibular molars of 3D-printed surgical jaw models were divided into two groups: PIEZO + DNS (n = 24) and PIEZO + FH (n = 24). Cone-beam computed tomography scans were taken before and after the procedure. The procedure was virtually planned on X-guide software. The bone-window cutting and RER were conducted with a PIEZO under dynamic navigation in the PIEZO + DNS group and using the dental operating microscope in the PIEZO + FH group. The 2D- and 3D-accuracy deviations and angular deflection were measured for the bone window cut. The root length resected and resection angle were calculated. The bone window cut, RER, total operating time, and number of mishaps were recorded. PIEZO + DNS was more accurate than PIEZO + FH for bone-window cutting, showing fewer 2D and 3D deviations and less angular deflection (P <.05). The resection angle was lower in the PIEZO + DNS (P <.05). The bone-window cut and total operating time were significantly reduced using a DNS (P <.05). There was no difference in the number of mishaps (P >.05). Within the limitations of this in vitro study, the integration of a PIEZO into a DNS is feasible for bone-window guided surgery. The DNS improved the accuracy and efficiency of bone-window cutting. [ABSTRACT FROM AUTHOR]

Background/purpose: The success of transcrestal sinus floor elevation (TSFE) is primarily reliant upon the experience of the surgeon owing to the limited operative visibility. To evaluate the accuracy associated with the use of a dynamic navigation system when conducting posterior maxilla implant surgery with TSFE. Materials and methods: Twenty-eight implants were placed in 28 patients requiring implantation in the posterior maxilla via a TSFE approach. The drills were used to access the planned position (within 1 mm of the bottom of the maxillary sinus floor) under dynamic navigation system. TSFE was then accomplished using osteotomes and a piezoelectric device. Lastly, the implant was inserted under the dynamic navigation. Three effective deviations between planned and actual implant placement were then measured including angular deviation (AD, degrees), entry point horizontal deviation (EPHD, mm), and apical point horizontal deviation (APHD, mm). Results: The AD, EPHD, and APHD between the planned and actual implant placement were 3.656 ± 1.665°, 1.073 ± 0.686 mm, and 1.086 ± 0.667 mm, respectively. Premolar site AD values were less than those for molar sites (P = 0.004). No significant differences in these outcomes were observed in different surgeons. Obvious sinus perforation was not detected by immediate postoperative cone beam computed tomography imaging. Conclusion: The accuracy associated with using a dynamic navigation system when conducting posterior maxilla implant surgery via a TSFE approach using piezoelectric devices was comparable. This technique thus achieved appropriate interventional precision and safety while decreasing the morbidity associated with the TSFE approach.

Purpose: Dynamic navigation is a technique that allows for the placement of dental implants using a computer-guided approach according to preoperative planning. Its accuracy has been assessed in several previous studies. The purpose of this study was to summarize data on implant placement accuracy using dynamic navigation, to synthesize the frequency of intraoperative complications and implant failures, and to compare this technique with static computer-guided surgery and a freehand approach. Materials and Methods: Electronic and manual literature searches until December 2019 were performed. The outcome variables were implant placement accuracy using dynamic navigation, accuracy differences between dynamic and static techniques and between dynamic and freehand techniques, intraoperative complications, and implant failures. Random-effects meta-analyses were performed. Results: A total of 32 studies were included; 29 reported accuracy values (2,756 implants), and 10 focused on complications and implant failures (1,039 implants). The pooled mean implant placement errors were 0.81 (95% CI: 0.677 to 0.943) mm at the entry point and 0.910 (95% CI: 0.770 to 1.049) mm at the apical point. The pooled mean vertical and angular deviations were 0.899 (95% CI: 0.721 to 1.078) mm and 3.807 (95% CI: 3.083 to 4.530) degrees. The navigation group showed significantly lower implant placement errors with respect to the freehand technique (P < .01) and similar accuracy values (P = .05) compared with the static technique. The pooled prevalence of failures was 1% (95% CI: 0.00% to 2%). Conclusion: Dynamic navigation provided small implant placement errors, comparable with those obtained using static computer-guided surgery, and can be considered a more accurate technique than conventional freehand surgery. [ABSTRACT FROM AUTHOR]

Purpose: Despite the high clinical accuracy of dynamic navigation, inherent sources of error exist. The purpose of this study was to improve the accuracy of dynamic-navigated surgical procedures in the edentulous maxilla by identifying the optimal configuration of intraoral points that results in the lowest possible registration error for direct clinical implementation. Materials and Methods: Six different four-area configurations (left and right sides; n = 12) were tested by three operators against two negative controls (left and right sides) and one positive control (three-area and eight-area configurations, respectively) using a skull model. The two dynamic navigation systems (X-Guide and Navident) and the two registration methods (bone surface tracing and fiducial markers) produced four registration groups: XG tracing, ND tracing, XG fiducial, and ND fiducial. The accuracy of the registration was checked at the frontal process of the zygoma. Intra- and interoperator reliabilities were reported for each registration group. Multiple comparisons were conducted to find the best configuration with the minimum registration error. Results: Ranking revealed one configuration in the tracing groups (Conf.3) and two configurations in the fiducial groups (Conf.3 and Conf.5) that had the best accuracy. When the inferior surfaces of the zygomatic buttress were excluded, fiducial registration produced better accuracy with both systems (P = .006 and < .0001). However, bilaterally tracing 1-cm areas at these surfaces resulted in similar registration accuracy to placing fiducial markers there (P = .430 and .237). Navident performed generally better (P = .049, .001, and .002), but the values had a wider margin of uncertainty. Changing the distribution of the four tracing areas or fiducial markers had a less pronounced effect with the X-Guide than with the Navident system. Conclusions: For surgery in the edentulous maxilla, four fiducial markers placed according to Conf.3 or Conf.5 resulted in the lowest registration error. Where implants are being placed bilaterally, an additional two sites may further reduce the error. For bilateral zygomatic implant placement, it is optimal to place two fiducial markers on the inferior surfaces of the maxillary tuberosities, two on their buccal surfaces, and another two on the anterior labial surface of the alveolar bone. Utilizing the inferior zygomatic buttress is recommended over the inferior maxillary tuberosities in other types of maxillary surgeries. [ABSTRACT FROM AUTHOR]

BackgroundImmediate implant placement (IIP), which preserves gingival height and papilla shape while simultaneously accelerating the implant treatment period, has become a popular method due to its commendable clinical outcomes. Nonetheless, deploying immediate implants demands specific preconditions concerning the remaining alveolar bone. This poses a challenge to the accuracy of implant surgery.Case presentationIn this report, we present the case of a 60-year-old woman with a left upper anterior tooth crown dislodged for over a month. Cone beam computed tomography (CBCT) revealed the absence of a labial bone wall on tooth 22, a remaining 1 mm bone wall on the labial side of the root apex, and a 17.2 mm*8.9 mm*4.7 mm shadow in the periapical region of the root apices of teeth 21 and 22, with the narrowest width on the sagittal plane being approximately 5 mm. After the surgeon removed the cyst, they completed the subsequent implantation surgery using an autonomous robot in a challenging aesthetic area. This method circumvented the potential exposure of the screw thread on the labial implant surface, assured initial implant stability.ConclusionFive months after the operation, the dental crown was restored. The implant remained stable, with yielding notable clinical results. To the best of our knowledge, this clinical case is the first to report the feasibility and precision of immediate implantation in anterior teeth site with periapical cyst removal, performed by an autonomous robotic surgical system. Autonomous robots exhibit exceptional accuracy by accurately controlling axial and angular errors. It can improve the accuracy of implant surgery, which may become a key technology for changing implant surgery. However, further clinical trials are still needed to provide a basis for the rapid development of robotic surgery field.

Objectives: To evaluate the accuracy of implant placement using a dynamic navigation system in fully edentulous jaws and to analyze the influence of implant distribution on implant position accuracy. Materials and Methods: Edentulous patients who received implant placement using a dynamic navigation system were included. Four to six mini screws were placed in the edentulous jaw under local anesthesia as fiducial markers. Then patients received CBCT scans. Virtual implant positions were designed in the planning software based on CBCT data. Under local anesthesia, implants were inserted under the guidance of the dynamic navigation system. CBCTs were taken following implant placement. The deviation between the actual and planned implant positions was measured by comparing the pre‐ and postsurgery CBCT. Results: A total of 13 edentulous patients with 13 edentulous maxillae and 7 edentulous mandibles were included, and 108 implants were placed. The average linear deviations at the implant entry point and apex were 1.08 ± 0.52 mm and 1.15 ± 0.60 mm, respectively. The average angular deviation was 2.85 ± 1.20°. No significant difference was detected in linear and angular deviations between the maxillary and mandibular implants, neither between the anterior and posterior implants. Conclusions: The dynamic navigation system provides high accuracy for implant placement in fully edentulous jaws, while the distribution of the implants showed little impact on implant position accuracy. [ABSTRACT FROM AUTHOR]

Augmented reality (AR) superimposes high-definition computer-generated virtual content onto the existing environment, providing users with an enhanced perception of reality. This study investigates the feasibility of integrating an AR head-mounted device into a 3-dimensional dynamic navigation system (3D-DNS) for osteotomy and root-end resection (RER). It compares the accuracy and efficiency of AR + 3D-DNS to 3D-DNS for osteotomy and RER. Seventy-two tooth roots of 3D-printed surgical jaw models were divided into two groups: AR + 3D-DNS (n = 36) and 3D-DNS (n = 36). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were virtually planned on X-guide software and delivered under 3D-DNS guidance. For the AR + 3D-DNS group, an AR head-mounted device (Microsoft HoloLens 2) was integrated into the 3D-DNS. The 2D- and 3D-deviations were calculated. The osteotomy and RER time and the number of procedural mishaps were recorded. Osteotomy and RER were completed in all samples (72/72). AR + 3D-DNS was more accurate than 3D-DNS, showing lower 2D- and 3D-deviation values (P <.05). The AR + 3D-DNS was more efficient in time than 3D-DNS (P <.05). There was no significant difference in the number of mishaps (P >.05). Within the limitations of this in vitro study, the integration of an AR head-mounted device to 3D-DNS is feasible for osteotomy and RER. AR improved the accuracy and time efficiency of 3D-DNS in osteotomy and RER. Head-mounted AR has the potential to be safely and reliably integrated into 3D-DNS for endodontic microsurgery. [ABSTRACT FROM AUTHOR]

The success of transcrestal sinus floor elevation (TSFE) is primarily reliant upon the experience of the surgeon owing to the limited operative visibility. To evaluate the accuracy associated with the use of a dynamic navigation system when conducting posterior maxilla implant surgery with TSFE. Twenty-eight implants were placed in 28 patients requiring implantation in the posterior maxilla via a TSFE approach. The drills were used to access the planned position (within 1 mm of the bottom of the maxillary sinus floor) under dynamic navigation system. TSFE was then accomplished using osteotomes and a piezoelectric device. Lastly, the implant was inserted under the dynamic navigation. Three effective deviations between planned and actual implant placement were then measured including angular deviation (AD, degrees), entry point horizontal deviation (EPHD, mm), and apical point horizontal deviation (APHD, mm). The AD, EPHD, and APHD between the planned and actual implant placement were 3.656 ± 1.665°, 1.073 ± 0.686 mm, and 1.086 ± 0.667 mm, respectively. Premolar site AD values were less than those for molar sites (P = 0.004). No significant differences in these outcomes were observed in different surgeons. Obvious sinus perforation was not detected by immediate postoperative cone beam computed tomography imaging. The accuracy associated with using a dynamic navigation system when conducting posterior maxilla implant surgery via a TSFE approach using piezoelectric devices was comparable. This technique thus achieved appropriate interventional precision and safety while decreasing the morbidity associated with the TSFE approach. [ABSTRACT FROM AUTHOR]

Objectives: This study was aimed at evaluating the clinical and radiological outcomes of novel dynamic navigation (DN)–aided endodontic microsurgery (EMS), with an analysis of potential prognostic factors. Materials and methods: Forty-six teeth from 32 patients who received DN-aided EMS were included. Clinical and radiographic assessments were performed at least 1 year postoperatively. Two calibrated endodontists assessed radiological outcomes according to two-dimensional (2D) periapical radiography (PA) and three-dimensional (3D) cone-beam computed tomography (CBCT) imaging using Rud's and Molven's criteria and modified PENN 3D criteria, respectively. Fisher's exact test was used for statistical analysis of the predisposing factors. Results: Of the 32 patients with 46 treated teeth, 28 with 40 teeth were available for follow-up. Of the 28 patients, four (five teeth) refused to undergo CBCT and only underwent clinical and PA examinations, and the remaining 24 (35 teeth) underwent clinical, PA, and CBCT examinations. Combined clinical and radiographic data revealed a 95% (38/40) success rate in 2D healing evaluations and a 94.3% (33/35) success rate in 3D healing evaluations. No significant effect was found in sex, age, tooth type, arch type, preoperative lesion volume, preoperative maximum lesion size, presence/absence of crown and post, and the root canal filling state on the outcome of DN-aided EMS. Conclusions: DN-aided EMS has a favorable prognosis and could be considered an effective and reliable treatment strategy. Further investigations with larger sample sizes are required to confirm these results. Clinical relevance: DN-aided EMS could be considered an effective and reliable treatment strategy. [ABSTRACT FROM AUTHOR]

This study aimed to compare the accuracy and efficiency of dynamic navigation–assisted endodontic microsurgery (DN-EMS) using two different registration methods. Three-dimensional-printed jaw models, including 40 teeth, were divided into two groups (n = 20). Cone-beam computed tomography images of all teeth were scanned under the same exposing parameters. An endodontic dynamic navigation system (DHC-ENDO1) was used to plan the drilling paths. Dynamic navigation–assisted endodontic microsurgery (DN-EMS) was performed using either U-shaped tube (UT) or tooth cusp (TC) registration method. The accuracy was determined by platform deviation, end deviation, angular deviation, resection angle, and resection length deviation. The registration efficiency was defined as the time required to complete the registration procedure. Osteotomy volume of each resection was calculated by Mimics 21.0. Statistical analyses were performed using IBM SPSS Statistics 24.0. Comparisons between groups were performed using the independent sample t test or Mann-Whitney U test. P <.05 was adopted as significant difference. The UT group was significantly more accurate in terms of mean platform deviation, end deviation, angular deviation, and resection angle (P <.05). Resection length deviation did not differ significantly between the registration groups. The UT group was significantly more efficient than the TC group (P <.05). No significant differences were found in the osteotomy volumes between the two groups. In the model-based surgical simulation comparison, DN-EMS based on UT registration is more accurate and efficient than the TC method but requires an additional registration device. TC technique may be a reasonable alternative to UT registration in certain clinical tasks. [ABSTRACT FROM AUTHOR]

Successful implantation in augmented areas relies on adequate bone density and quality, along with thorough planning. The minimisation of the risks involved in the surgery and recovery phases is also of tremendous relevance. The aims of the present research were to clinically and biochemically evaluate the healing process after implant surgery (dental implants) using dynamic surgical navigation following prior bone augmentation. Thirty healthy patients who had implant treatment were analysed. The study participants (30 patients) were randomised between two groups. The 15 patients in the study group were treated with Navident dynamic navigation by using a flapless technique. The control group included 15 subjects in whom the implantation procedure was performed classically using the elevation flap full-thickness method. In all cases, the patient's clinical condition, the patient's subjective visual assessment of post-operative pain using the Visual Analogue Scale (VAS), and the levels of the salivary biomarkers interleukin 6 (IL 6) and C-reactive protein (CRP) immediately before surgery on the first post-operative day and on the seventh post-operative day were assessed. The healing process was shown to be faster in patients in the study group due to the low invasiveness of the treatment, which was confirmed by lower levels of pro-inflammatory cytokines in the study group versus the control group. The statistical analysis used Student's t-test and Mann–Whitney test. The implementation of dynamic navigation and the application of the flapless technique reduced post-operative trauma, leading to a reduced risk of infection, reduced patient discomfort, and faster recovery. [ABSTRACT FROM AUTHOR]

This case report demonstrates the use of dynamic navigation guidance for bone reduction. Information about smile line position incorporated in a virtual plan and accurate transfer to the surgical field enhances the predictability of the treatment. A virtual wax-up was made, and implant positions along with bone reduction were planned accordingly. Residual teeth in the maxilla were extracted, and bone reduction and zygomatic implant placement were assisted by surgical navigation, while conventional implants were placed using the surgical template, followed by immediate loading. When surgical navigation is used for implant placement, navigated bone reduction can easily be incorporated in the workflow. The accuracy of bone reduction was evaluated together with the accuracy of two zygomatic implants assisted by a navigation system and four conventional implants assisted by a static template. The mean deviation between planned and performed bone reduction was 1.3 ± 0.39 mm (range: 0.8 to 1.7 mm). The accuracy of this procedure corresponds to the accuracy of guided implant placement and can be considered reliable after confirmation through clinical trials. [ABSTRACT FROM AUTHOR]

The advent of guided endodontics, combining 3D imaging techniques with digitally designed guides, has led to its utilisation in surgical and nonsurgical root canal treatment. To date, however, guided endodontics has focused mainly on static guidance, with dynamic guidance receiving limited attention. In the present case report, a dynamic navigation implant system was used for guided endodontics. The safe and accurate access cavity preparation, location and negotiation of the calcified canals of a maxillary second premolar demonstrate the successful clinical application of dynamic guided endodontics in everyday endodontic practice. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the influence of field of view (FOV) and voxel size on the accuracy of dynamic navigation (DN)–assisted endodontic microsurgery (EMS). Nine sets of maxillary and mandibular 3-dimensional–printed jaw models composed of 180 teeth were divided into 9 groups with different FOVs (80 × 80 mm, 60 × 60 mm, and 40 × 40 mm) and voxel sizes (0.3 mm, 0.16 mm, and 0.08 mm). The endodontic DN system was used to plan and execute the EMS. The accuracy of the DN-EMS was represented by the platform deviation, end deviation, angular deviation, resection angle, and resection length deviation. Statistical analyses were performed using SPSS 24.0, and the significance level was set at P <.05. The average platform deviation, end deviation, angular deviation, resection angle, and resection length deviation were 0.69 ± 0.31 mm, 0.93 ± 0.44 mm, 3.47 ± 1.80°, 2.35 ± 1.76°, and 0.41 ± 0.29 mm, respectively. No statistically significant differences in accuracy were observed between the nine FOV and voxel size groups. FOV and voxel size did not appear to play an important role in the accuracy of DN-EMS. Considering the image quality and radiation dose, it is reasonable to select a limited FOV (such as 40 × 40 mm and 60 × 60 mm) to cover only the registration device, involved teeth, and periapical lesion. The voxel size should be selected according to the required resolution and cone-beam computed tomography units. [ABSTRACT FROM AUTHOR]

This study compared the accuracy and efficiency of fully guided static and dynamic computer-assisted surgical navigation techniques for osteotomy and root-end resection (RER). Fifty roots from cadaver heads were divided into two groups: fully guided static computer-assisted endodontic microsurgery (FG sCAEMS) and dynamic computer-assisted endodontic microsurgery (dCAEMS) (all, n = 25). Cone-beam computed tomography scans were taken pre and postoperatively. The osteotomy and RER were planned virtually in the preoperative cone-beam computed tomography scan and guided using 3D-printed surgical guides in the FG sCAEMS and 3D-dynamic navigation system in the dCAEMS. The 2D and 3D deviations and angular deflection were calculated. The osteotomy volume, resected root length, and resection angle were measured. The osteotomy and RER time and the number of procedural mishaps were recorded. FG sCAEMS was as accurate as dCAEMS, with no difference in the 2D and 3D deviation values or angular deflection (P >.05). The osteotomy and RER time were shortened using FG sCAEMS (P <.05). The FG sCAEMS showed a greater number of incomplete RERs than dCAEMS. Osteotomy volume, RER angle, and root length resected were similar in both groups (P >.05). FG sCAEMS and dCAEMS were feasible for osteotomy and RER. Within the limitations of this cadaver-based study, FG sCAEMS was as accurate as dCAEMS. Both FG sCAEMS and dCAEMS were time-efficient for osteotomy and RER. [ABSTRACT FROM AUTHOR]

Introduction: Zygomatic implants are an effective solution for rehabilitation of edentulous atrophic maxillae. However, the conventional technique of zygomatic implant placement is invasive, requires a longer healing period and is economically cumbersome. Therefore, the flapless technique of insertion of zygomatic implants using dynamic navigation system has been introduced. This study aims to compare the cost-effectiveness of flapless insertion of zygomatic implants using dynamic navigation to the conventional flap technique. Materials and Methods: The study participants were divided into two groups: Group A (n = 20) included patients treated by flapless insertion of zygomatic implants using dynamic navigation and Group B (n = 20) included patients treated with zygomatic implants using the flap technique. An analysis of the effectiveness of the implants was done using the concept of quality-adjusted prosthesis years, and an analysis of the costs was done by evaluating the treatment costs at each step. The data were collected, and analysis was done using IBM SPSS software. The Kruskal–Wallis rank-sum test was employed to analyse variations in costs and effects between the two groups. Results: The study showed that the distribution of costs varies across both the categories of the procedure. Group B shows lesser cost-effectiveness as compared to Group A. Conclusion: The technique of flapless insertion of zygomatic implants is cost-effective. However, further studies considering factors such as time and cost of productivity evaluating the cost-effectiveness should be conducted. [ABSTRACT FROM AUTHOR]

The size and the position of the sinus antrostomy play a key role in making sinus grafting surgery more predictable and effective with less complications. A cone beam computed tomography and intraoral scan of the maxilla were taken for a patient who is missing maxillary first molar tooth with limited residual bone. Data were exported to the dynamic navigation (DN) system software. Sinus lateral window osteotomy position and dimensions were determined and planned using four 1.5 mm diameter implants placed on the maxillary sinus lateral wall. The osteotomy was initiated following the planned four 1.5 mm implants in a parallel motion to the bone surface using dynamic navigation guidance; thus, creating an outline for the lateral sinus window. Afterword's, the lateral sinus window was greenstick fractured and the membrane was lifted; first molar implant osteotomy done, implant placed, and bone graft material was placed. The flap was sutured, and post-operative instructions and medications were given. No post-operative complications noticed. The outline of the lateral window osteotomy along with implant osteotomy can be accurately planned and executed using DN technology, which may potentially reduce complications and insure accurate placement of the implant and the graft. [ABSTRACT FROM AUTHOR]

Abstract Purpose This study aimed to compare the accuracy of fully guided between dynamic and static computer-assisted implant surgery (CAIS) systems for immediate implant placement in the esthetic zone. Methods A total of 40 qualified patients requiring immediate implant placement in the esthetic zone were randomly and equally assigned to either static CAIS group (n = 20) or dynamic CAIS groups (n = 20). Global deviations at entry, apex, and angular deviation between placed and planned implant position were measured and compared as primary outcomes. Secondary outcomes were the deviation of implant placement at mesial–distal, labial–palatal, and coronal–apical directions. Results For the immediate implant placement, the mean global entry deviations in static and dynamic CAIS groups were 0.99 ± 0.63 mm and 1.06 ± 0.55 mm (p = 0.659), while the mean global apex deviations were 1.50 ± 0.75 mm and 1.18 ± 0.53 mm (p = 0.231), respectively. The angular deviation in the static and dynamic CAIS group was 3.07 ± 2.18 degrees and 3.23 ± 1.67 degrees (p = 0.547). No significant differences were observed for the accuracy parameters of immediate implant placement between static and dynamic CAIS systems, except the deviation of the implant at entry in the labial–palatal direction in the dynamic CAIS group was significantly more labial than of the static CAIS (p = 0.005). Conclusions This study demonstrated that clinically acceptable accuracy of immediate implant placement could be achieved using static and dynamic CAIS systems. Trial registration ChiCTR, ChiCTR2200056321. Registered 3 February 2022, http://www.chictr.org.cn/showproj.aspx?proj=151348

Abstract Purpose This study aimed to investigate the performance of novice versus experienced practitioners for placing dental implant using freehand, static guided and dynamic navigation approaches. Methods A total of 72 implants were placed in 36 simulation models. Three experienced and three novice practitioners were recruited for performing the osteotomy and implant insertion with freehand, surgical guide (pilot-drill guidance) and navigation (X-Guide, X-Nav technologies) approaches. Each practitioner inserted 4 implants per approach randomly with a 1-week gap to avoid memory bias (4 insertion sites × 3 approaches × 6 practitioners = 72 implants). The performance of practitioners was assessed by comparing actual implant deviation to the planned position, time required for implant placement and questionnaire-based self-confidence evaluation of practitioners on a scale of 1–30. Results The navigation approach significantly improved angular deviation compared with freehand (P

Objectives: To assess the relative accuracy of manual (U‐shaped tube) and automatic (two‐in‐one) dynamic navigation registration techniques for implant surgery performed in posterior sites missing one tooth. Materials and Methods: This study included 58 partially edentulous patients with 58 implants, including 31 and 27 in the manual and automatic groups. Deviations between the planned and actual implant placement were assessed. Results: The angular deviation in the overall study cohort was 2.54 ± 1.21°, while the 3D deviations at the implant platform and apex were 0.90 ± 0.46 mm and 1.04 ± 0.47 mm, respectively. The respective angular deviations in the manual and automatic groups were 2.82 ± 1.17° and 2.21 ± 1.19° (p >.05), while platform deviations were 0.89 ± 0.48 mm and 0.91 ± 0.45 mm (p >.05), and apex deviations were 0.99 ± 0.48 mm and 1.11 ± 0.46 mm (p >.05). No significant differences in absolute buccolingual, mesiodistal, or apicocoronal deviations were detected between these groups at either level (p >.05) nor were did deviation distributions differ in the buccolingual, mesiodistal, or apicocoronal directions at the platform or apex levels (p >.05). Conclusions: Manual and automatic dynamic navigation registration techniques can achieve excellent accuracy when placing implants in posterior sites missing a single tooth. The two‐in‐one automatic registration technique can reduce the amount of time and intraoperative steps necessary to complete the registration process relative to the manual U‐shaped tube registration technique. Further follow‐up studies are necessary to expand on these results. [ABSTRACT FROM AUTHOR]

This study aimed to compare the effects of static navigation (SN), a dynamic navigation system (DNS), and the freehand (FH) technique in root end resection and the differences between these effects according to the level of experience of the operator. Maxillary models reconstructed with Mimics software (Materialise, Leuven, Belgium) were 3-dimensionally printed and divided according to the experimental technique (FH, SN, or DNS) and the operator (experienced or inexperienced). SN was designed using 3-matic Medical software (Materialise) and printed, and a surgical approach plan for DNS was established and performed using DCARER (Suzhou, China) software. The accuracy, efficiency, and safety of the resections were assayed. The length, angle, volume, and depth deviations of the root end resections were significantly lower in the SN and DNS group compared with the FH group. SN significantly improved the efficiency of both operators, whereas DNS only improved the efficiency of the inexperienced operator. No difference between the SN and DNS groups was found, except for the time required for the surgery. No mishaps occurred during surgery in the SN or DNS group. The number of mishaps with the FH technique when used by the inexperienced operator was significantly higher than that registered for the rest of the groups. No interaction effect between technique and operator experience level was detected. Regardless of operator experience, both SN and DNS could improve the accuracy and safety of root end resection. SN significantly improved the chairside efficiency of both operators, whereas DNS was more helpful for the inexperienced operator. [ABSTRACT FROM AUTHOR]