Does Dynamic Navigation System Preserve More Dentine? - A Systematic Review

Overview

Journal BMC Oral Health

Publisher Biomed Central

Specialty Dentistry

Date 2024 Jun 10

PMID 38858636

Authors

Akshayraj Langaliya

Selvakumar Kritika

Aarshvi Shah

Jinali Shah

Sekar Mahalaxmi

Affiliations

Soon will be listed here.

Abstract

Objective: This systematic review aims to comparatively analyse the amount of dentin removal by free hand and static guided endodontics with dynamic navigation system (DNS) in endodontic access cavity preparation.

Methods: The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Based on the structured PICO framework of "Comparative evaluation of dynamic navigation system (I) to freehand (C) and static guided endodontics (C) in endodontic access cavity preparation on the preservation of tooth structure (O) when assessed on permanent human teeth (P)", the keywords were formulated and the articles were retrieved from three databases namely PubMed, Scopus and Embase, based on the keywords from the time of inception of DNS till June 2023. The risk of bias assessment was done using a modified Joanne Briggs Institute checklist, which evaluated domains such as randomisation, sample size, image acquisition using CBCT, angulation, accuracy and time taken. As the data was heterogenous, a quantitative meta-analysis was not performed.

Results: Initially, 174 articles were retrieved from the three databases, 30 duplicates were removed, after title check 108 articles were excluded and following abstract check only 10 articles qualified for full text analysis. On reviewing the 10 full text articles, 5 articles were excluded and the remaining 5 articles were subjected to the risk of bias analysis which showed that 2 articles displayed low risk of bias and three articles showed high risk of bias. The RoB analysis revealed that only 2 studies evaluated the preservation of dentin in terms of accuracy, angulation and time taken proving the increased precision with minimal loss of tooth structure using DNS. In both the studies, DNS proved to be superior to free hand technique in terms of precision, accuracy and efficiency in locating the canals during access cavity preparation with maximal preservation of tooth structure.

Conclusion: With the minimal literature evidences, the present systematic review highlights maximal preservation of dentin using DNS. However, further invitro and invivo studies comparing the free hand, static guided endodontics to DNS must be carried out for its translation into clinical practice.

Clinical Significance: Dynamic navigation system provides maximal preservation of dentin during access cavity preparation.

Citing Articles

Guided Endodontics for Non-surgical Root Canal Retreatment: A Systematic Review.

Samiei M, Sabanik P, Tavakkoli Avval S Iran Endod J. 2025; 20(1):e3.

PMID: 39935861 PMC: 11808322. DOI: 10.22037/iej.v20i1.46903.

Impact of Guided Endodontics on the Success of Endodontic Treatment: An Umbrella Review of Systematic Reviews and Meta-Analyses.

Puri A, Abraham D, Gupta A Cureus. 2024; 16(9):e68853.

PMID: 39381454 PMC: 11459592. DOI: 10.7759/cureus.68853.

References

Buchgreitz J, Buchgreitz M, Bjorndal L . Guided root canal preparation using cone beam computed tomography and optical surface scans - an observational study of pulp space obliteration and drill path depth in 50 patients. Int Endod J. 2018; 52(5):559-568. DOI: 10.1111/iej.13038. View

Gambarini G, Galli M, Morese A, Stefanelli L, Abduljabbar F, Giovarruscio M . Precision of Dynamic Navigation to Perform Endodontic Ultraconservative Access Cavities: A Preliminary In Vitro Analysis. J Endod. 2020; 46(9):1286-1290. DOI: 10.1016/j.joen.2020.05.022. View

Connert T, Krug R, Eggmann F, Emsermann I, ElAyouti A, Weiger R . Guided Endodontics versus Conventional Access Cavity Preparation: A Comparative Study on Substance Loss Using 3-dimensional-printed Teeth. J Endod. 2019; 45(3):327-331. DOI: 10.1016/j.joen.2018.11.006. View

Pinsky H, Champleboux G, Sarment D . Periapical surgery using CAD/CAM guidance: preclinical results. J Endod. 2007; 33(2):148-51. DOI: 10.1016/j.joen.2006.10.005. View

Dianat O, Nosrat A, Tordik P, Aldahmash S, Romberg E, Price J . Accuracy and Efficiency of a Dynamic Navigation System for Locating Calcified Canals. J Endod. 2020; 46(11):1719-1725. DOI: 10.1016/j.joen.2020.07.014. View

Krastl G, Zehnder M, Connert T, Weiger R, Kuhl S . Guided Endodontics: a novel treatment approach for teeth with pulp canal calcification and apical pathology. Dent Traumatol. 2015; 32(3):240-246. DOI: 10.1111/edt.12235. View

Jonaityte E, Bilvinaite G, Drukteinis S, Torres A . Accuracy of Dynamic Navigation for Non-Surgical Endodontic Treatment: A Systematic Review. J Clin Med. 2022; 11(12). PMC: 9225421. DOI: 10.3390/jcm11123441. View

Connert T, Leontiev W, Dagassan-Berndt D, Kuhl S, ElAyouti A, Krug R . Real-Time Guided Endodontics with a Miniaturized Dynamic Navigation System Versus Conventional Freehand Endodontic Access Cavity Preparation: Substance Loss and Procedure Time. J Endod. 2021; 47(10):1651-1656. DOI: 10.1016/j.joen.2021.07.012. View

Martinho F, Griffin I, Corazza B . Current Applications of Dynamic Navigation System in Endodontics: A Scoping Review. Eur J Dent. 2022; 17(3):569-586. PMC: 10569848. DOI: 10.1055/s-0042-1749361. View

10.

Zehnder M, Connert T, Weiger R, Krastl G, Kuhl S . Guided endodontics: accuracy of a novel method for guided access cavity preparation and root canal location. Int Endod J. 2015; 49(10):966-72. DOI: 10.1111/iej.12544. View

11.

Reeh E, Messer H, Douglas W . Reduction in tooth stiffness as a result of endodontic and restorative procedures. J Endod. 1989; 15(11):512-6. DOI: 10.1016/S0099-2399(89)80191-8. View

12.

Torres A, Boelen G, Lambrechts P, Pedano M, Jacobs R . Dynamic navigation: a laboratory study on the accuracy and potential use of guided root canal treatment. Int Endod J. 2021; 54(9):1659-1667. DOI: 10.1111/iej.13563. View

13.

Talwar N, Singh B, Chand P, Pal U . Use of diagnostic and surgical stent: a simplified approach for implant placement. J Indian Prosthodont Soc. 2011; 10(4):234-9. PMC: 3056959. DOI: 10.1007/s13191-010-0036-7. View

14.

Lang H, Korkmaz Y, Schneider K, Raab W . Impact of endodontic treatments on the rigidity of the root. J Dent Res. 2006; 85(4):364-8. DOI: 10.1177/154405910608500416. View

15.

Jain S, Saunders M, Carrico C, Jadhav A, Deeb J, Myers G . Dynamically Navigated versus Freehand Access Cavity Preparation: A Comparative Study on Substance Loss Using Simulated Calcified Canals. J Endod. 2020; 46(11):1745-1751. DOI: 10.1016/j.joen.2020.07.032. View

16.

Vasudevan A, Santosh S, Selvakumar R, Sampath D, Natanasabapathy V . Dynamic Navigation in Guided Endodontics - A Systematic Review. Eur Endod J. 2022; 7(2):81-91. PMC: 9285996. DOI: 10.14744/eej.2022.96168. View

17.

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021; 372:n71. PMC: 8005924. DOI: 10.1136/bmj.n71. View

18.

Emery R, Merritt S, Lank K, Gibbs J . Accuracy of Dynamic Navigation for Dental Implant Placement-Model-Based Evaluation. J Oral Implantol. 2016; 42(5):399-405. DOI: 10.1563/aaid-joi-D-16-00025. View

19.

Jain S, Carrico C, Bermanis I . 3-Dimensional Accuracy of Dynamic Navigation Technology in Locating Calcified Canals. J Endod. 2020; 46(6):839-845. DOI: 10.1016/j.joen.2020.03.014. View

20.

Zubizarreta-Macho A, Valle Castano S, Montiel-Company J, Mena-Alvarez J . Effect of Computer-Aided Navigation Techniques on the Accuracy of Endodontic Access Cavities: A Systematic Review and Meta-Analysis. Biology (Basel). 2021; 10(3). PMC: 7999608. DOI: 10.3390/biology10030212. View