Dynamic navigation—The future of minimally invasive endodontics

Fig. 1a: Static navigation stent used for endodontic access cavity preparations. The pre-planned stent does not allow for reorientation of the drill during the preparation. This can be consequential in accessing calcified, sclerosed canals. (Courtesy of Dr Paula Villa)

Fig. 1b: Three-dimensional stent printed for static navigation guidance to facilitate removal of an instrument in the periapex. Stents are cumbersome, bulky and restrictive in posterior regions. Once planned, the osteotomy path cannot be altered. (Courtesy of Dr Hugo Sousa Dias)

Fig. 2: An optical tracking sensor tracks the Jaw-Tracker, Tracer Tracker, Drill-Tracker and instrument.

Fig. 3: The screen is divided into (1) panoramic view, (2) 3D reconstruction, (3) axial view, and (4) buccolingual and (5) mesiodistal section views.

Fig. 4a: The planned axis angulation and orientation of the virtual drill are exacting in targeting calcified canals. (Courtesy of Dr Bobby Nadeau)

Fig. 4b: The red virtual pathway reflects an off-angle positioning. (Courtesy of Dr Bobby Nadeau)

Fig. 4c: Piezotome planning. (Courtesy of Dr Bobby Nadeau)

Fig. 5: The three landmarks chosen are not collinear, and the centre of the thin red cross-hair that appears is focused on the surface of the landmark.

Fig. 6: (1) The Jaw-Tracker is installed. (2) During tracing, the system presents the percentage sampled up to 100 %.

Fig. 7: The Tracer-Tag and the Tracer-Tool are attached, the Tracer-Tool calibrated. The software shows the number of points contacted as a percentage.

Fig. 8a: Calibration of the drill axis and the instrument tip.

Fig. 8b: The Drill-Tag (optical tracking tag).

Fig. 9a: Calcified central incisor: (1) the drill is green; (2) the central axis of the glide path or osteotomy; (3) the depth indicator; (4) the angle between the drill and central axis of the planned osteotomy. When the drill and the central axis overlap, the depth indicator turns yellow. (Courtesy of Dr Bobby Nadeau)

Fig. 9b: Maxillary molar: the planned canal location is on target (yellow: 0 mm). (Courtesy of Dr Bobby Nadeau)