OBJECTIVE: To evaluate the accuracy of the implant accuracy and clinical effect of navigation-assisted immediate implant placement (IIP) in the posterior maxillary tooth region.
METHODS: This study included 60 patients with 96 implants undergoing IIP in the posterior maxillary region from January 2021 to December 2022, stratified into dynamic navigation and freehand implant groups. All clinical indicators, including initial stability, implant deviation (entry point deviation, end point deviation, depth deviation and angle deviation), marginal bone resorption and implant success rate, were systematically recorded.
RESULTS: All implants were successfully placed with an average torque of (24.38 ± 1.84)N.cm. The mean entry point deviation, apex point deviation and angular deviation in the navigation group were significantly smaller than that of the freehand group (P < 0.05). Marginal bone resorption was significantly less in the navigated group than in the freehand group (P < 0.05). All dental implants were considered an operational success and the mean follow-up time was (27.8 ± 8.4) months.
CONCLUSIONS: The application of dynamic navigation-assisted immediate implant placement in the maxillary posterior region can achieve good implant accuracy and satisfactory clinical results.

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 to the free hand (4.151.29) were statistically significant. The variation in the free-hand group was greater than the navigation method at the apex (3D)(p<0.05). 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\'s the need of the hour for clinicians to master this technology and thereby aid in better prognostic level of implant placements.

OBJECTIVE: To assess navigation accuracy for complete-arch implant placement with immediate loading of digitally prefabricated provisional.
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.

OBJECTIVE: Tooth preparation is complicated because it requires the preparation of an abutment while simultaneously predicting the ideal shape of the tooth. This study aimed to develop and evaluate a system using augmented reality (AR) head-mounted displays (HMDs) that provide dynamic navigation capabilities for tooth preparation.
METHODS: The proposed system utilizes optical see-through HMDs to overlay digital information onto the real world and enrich the user\'s environment. By integrating tracking algorithms and three-dimensional modeling, the system provides real-time visualization and navigation capabilities during tooth preparation by using two different visualization techniques. The experimental setup involved a comprehensive analysis of the distance to the surface and cross-sectional angles between the ideal and prepared teeth using three scenarios: traditional (without AR), overlay (AR-assisted visualization of the ideal prepared tooth), and cross-sectional (AR-assisted visualization with cross-sectional views and angular displays).
RESULTS: A user study (N = 24) revealed that the cross-sectional approach was more effective for angle adjustment and reduced the occurrence of over-reduction. Additional questionnaires revealed that the AR-assisted approaches were perceived as less difficult, with the cross-sectional approach excelling in terms of performance.
CONCLUSIONS: Visualization and navigation using cross-sectional approaches have the potential to support safer tooth preparation with less overreduction than traditional and overlay approaches do. The angular displays provided by the cross-sectional approach are considered helpful for tooth preparation.
CONCLUSIONS: The AR navigation system can assist dentists during tooth preparation and has the potential to enhance the accuracy and safety of prosthodontic treatment.

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.
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).
CONCLUSIONS: 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.

To quantify the reproducibility of the drill calibration process in dynamic navigation guided placement of dental implants and to identify the human factors that could affect the precision of this process in order to improve the overall implant placement accuracy.
A set of six drills and four implants were calibrated by three operators following the standard calibration process of NaviDent® (ClaroNav Inc.). The reproducibility of the position of each tip of a drill or implant was calculated in relation to the pre-planned implants\' entry and apex positions. Intra- and inter-operator reliabilities were reported. The effects of the drill length and shape on the reproducibility of the calibration process were also investigated. The outcome measures for reproducibility were expressed in terms of variability range, average and maximum deviations from the mean distance.
A satisfactory inter-rater reproducibility was noted. The precision of the calibration of the tip position in terms of variability range was between 0.3 and 3.7 mm. We noted a tendency towards a higher precision of the calibration process with longer drills. More calibration errors were observed when calibrating long zygomatic implants with non-locking adapters than with pointed drills. Flexible long-pointed drills had low calibration precision that was comparable to the non-flexible short-pointed drills.
The clinicians should be aware of the calibration error associated with the dynamic navigation placement of dental and zygomatic implants. This should be taken in consideration especially for long implants, short drills, and long drills that have some degree of flexibility.
Dynamic navigation procedures are associated with an inherent drill calibration error. The manual stability during the calibration process is crucial in minimising this error. In addition, the clinician must never ignore the prescribed accuracy checking procedures after each calibration process.

Aim The study aims to compare the accuracy of dynamic navigation (DN) and static guides (SGs) for simultaneous adjacent parallel placement of implants, the time taken for the surgery, and the ease of handling the instruments. Materials and methods This prospective trial was carried out at the Department of Implantology of Saveetha Dental College from October 2022 to February 2023. A total of 20 patients who needed simultaneous adjacent dental implants were allocated randomly into two groups: Group 1 SG surgery and Group 2 DN surgery. Forty implants were placed, 20 under DN and 20 under SG. Bucco-lingual displacement, apico-coronal displacement, mesiodistal displacement, and mesiodistal angulation were compared between the two groups. The patients\' data in both groups were evaluated by operating surgeons along with the surgical time taken and the ease of handling of instruments. Results The 20 patients who underwent implant placement in the DN and SG groups all had adjacent missing teeth in posterior sites, including lower posteriors (70%) and upper posteriors (30%). There was improved precision in relation to the mesiodistal displacement and angulation of the anterior implant of the adjacent parallel implants. The mesiodistal displacement in Group 1 (SG) was 5.61 + 3.1 mm, which was higher than Group 2 (DN), which was 0.55 + 0.56 mm. The mesiodistal angulation was 3.1 + 2.9 degrees in Group 2 and 0.42 + 0.5 degrees in Group 1. The second implant had a significant difference (p < 0.005) in mesiodistal displacement, mesiodistal angulation, and bucco-lingual displacement. The difference between the intergroup surgical time (mean + SD) in Group 1 was 30 + 4.5 mins and in Group 2 was 60.7 + 10.1 mins, with p < 0.05 statistically significant. The comfort of the operator was better in the SG group. Conclusion Any digitally aided implant placement technique can improve placement accuracy but each has its downfalls. Achieving the highest levels of precision and long-lasting prosthetic results hinges on both the suitability of the chosen case and the expertise of the surgeon performing the implant placement.

BACKGROUND: 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.
METHODS: 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.
RESULTS: 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).
CONCLUSIONS: In this surgical simulation comparison study, the incorporation of a pilot drill improved the accuracy and safety of DN-aided endodontic microsurgery.

OBJECTIVE: To assess root canal localization accuracy using a dynamic approach, surgical guides and freehand technique in vitro.
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.
CONCLUSIONS: Although guided endodontic access preparation may require more time compared to the freehand technique, the guided navigation is more accurate and saves tooth structure.

OBJECTIVE: This study aims to evaluate the accuracy associated with the use of a dynamic navigation system for the lateral window opening for a direct sinus floor elevation (SFE) procedure with simultaneous implant placement.
METHODS: A female patient, aged 27 years, reported to the Department of Implantology seeking treatment for her lost tooth. On radiographic examination, the residual alveolar ridge height was 6 mm in the 26 (left upper first molar) region. For the implant placement, the case was planned to be carried out under dynamic navigation (Navident, Claronav, Canada). To make the lateral window accessible to the sinus floor, an implant trajectory resembling the required window dimensions and prosthetic implant position was planned. Post-surgery cone beam computed tomography (CBCT) was taken to assess the accuracy of the lateral window and implant trajectories using Evalunav (Navident, Claronav, Canada) analysis with dynamic navigation software.
RESULTS: There was improved accuracy of the lateral window opening, and the visualization of the lateral window was maintained in real-time throughout the procedure, which was advantageous to eliminate the tearing of the thin sinus membrane. The deviations found in the trajectory of the lateral window in comparison between the planning and post-procedure were: (a) entry was deviated by 2.83 mm; (b) the apex was deviated by 2.52 mm; (c) vertically, the apex was deviated by 0.29 mm; and (d) there was an 8.93° deviation in the angulation of the trajectory. The implant that was placed simultaneously with the SFE\'s accuracy was in comparison with the position that was planned: (a) entry was deviated by 0.03 mm, (b) the apex was deviated by 0.82 mm, (c) vertically, the apex was deviated by 0.82 mm, and (d) there was a 0° deviation in the angulation of the trajectory.
CONCLUSIONS: Dynamic navigation technology can help overcome complications associated with direct sinus lift procedures by providing highly accurate and precise planning and execution of the surgical procedure. This can lead to improved implant stability and a reduced risk of complications.