Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-post Removal: Small versus Large Field-of-view Registration Workflows

Abstract

Introduction: This study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw).

Methods: Fifty-six extracted human maxillary molars were divided into DNS-SFOVw (n = 28) and DNS-LFOVw (n = 28). The palatal canal was restored with an intraradicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam computed tomography (CBCT) scan was taken with a 40 × 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional deviations, angular deflection, number of mishaps, registration, and total operation time were calculated.

Results: The DNS-SFOVw was as accurate as DNS-LFOVw (P > .05). The DNS-LFOVw registration time was less than DNS-SFOVw (P < .05). There was no difference in the number of mishaps (P > .05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (P < .05).

Conclusion: Within the limitations of this in-vitro study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiberpost removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.

Keywords: Dynamic navigation system; endodontics; post-removal; workflow.