Endodontic Microsurgery with the Aid of Dynamic Navigation System Using Minimally Invasive Incision Approach in Anatomically Complex Scenarios: A Case Series.

Abstract

Endodontic microsurgery (EMS) is an alternative treatment option for previously treated teeth with persistent periapical disease, offering a favorable prognosis. However, it can be particularly challenging in anatomically complex cases, risking unintentional damage to adjacent critical structures. Dynamic navigation (DN), a computer-aided technique, facilitates precise presurgical planning and provides real-time guidance during operation. Integrating the DN technique into EMS procedures can enhance treatment accuracy and effectiveness. This report presents 4 cases involving a minimally invasive incision approach for DN-aided EMS in anatomically complex regions, all of which were completed without complications. After 3-12 months, patients presented asymptomatic, and radiographic examinations revealed complete healing or the periapical radiolucent area decreased in size. The DN technique contributed to reliably mitigating the risk of iatrogenic damage in complicated EMS scenarios. The minimally invasive incision approach not only provided sufficient visibility but also promoted favorable soft tissue healing, making it a valuable addition to surgical endodontics.