Accuracy and Efficiency of a Dynamic Navigation System for Locating Calcified Canals.

INTRODUCTION Calcified canals present a challenge during endodontic treatments. The purpose of this study was to compare the accuracy and efficiency of a dynamic navigation system (DNS) to the freehand (FH) method for locating calcified canals in human teeth. METHODS Sixty human single-rooted teeth with canal obliteration were selected and mounted in dry cadaver jaws. Based on cone-beam computed tomography (CBCT) scans of the jaws, the drilling path and depth were virtually planned to use the X-guide software (X-Nav Technologies). Access preparation was made with navigation in the DNS group, and without guidance in the FH group by two operators with different levels of experience. Postoperative CBCT scans were taken of all teeth. Linear and angular deviations and reduced dentin thickness at two levels were measured. Time for locating the canal, number of mishaps, and unsuccessful attempts were determined and analyzed. RESULTS Mean linear and angular deviations, reduced dentin thickness (at both levels), time for access cavity preparation, and number of mishaps in the DNS group were significantly less than the FH group (P≤0.05). Unsuccessful attempts were not different between the two groups (P>0.05). Time for access preparation was significantly shorter for the board-certified endodontist in the FH group (P≤0.05). CONCLUSION The DNS was more accurate and more efficient than the free hand technique in locating calcified canals in human teeth. This novel dynamic navigation system can help clinicians avoid catastrophic mishaps during access preparation in calcified teeth.