(PO84) Assessing the Accuracy, Efficiency, and Precision of Dynamic Guidance in Endodontic Microsurgery

Abstract: This study aimed to assess the effect of dynamic guidance using the X-Guide system on osteotomy size, surgical time, and iatrogenic error in a standardized endodontic microsurgery model. Root end surgery was completed on the mesial root of the left first molar in 21 identical mandibular models by either the conventional Endodontic Microsurgery (EMS) or Dynamic Guidance Endodontic Microsurgery (DGEMS). The procedures were randomized, with seven postgraduate endodontics residents completing three procedures each, including at least one EMS and one DGEMS procedure. On the day of the surgery, the duration of the osteotomy and root resection was timed. The models underwent a post-operative CBCT and were evaluated by a blinded evaluator, who assessed the length and angle of root resection, the widest mesiodistal and superior-inferior (S/I) dimensions of the osteotomy, the depth of buccal and lingual canal root-end filling, adequate preparation of the isthmus, iatrogenic damage to adjacent structures, and the volume of the osteotomy. No differences were found between the groups in surgical time, length and angle of root resection, depth and adequacy of root-end filling, iatrogenic damage to adjacent structures, or volume of the osteotomy (p > .05). There were significant reductions in the DGEMS group in the mesiodistal and superior-inferior dimensions of the osteotomy at the cortical plate (p < .05). DGEMS provided reduced osteotomy dimensions without compromising the ability to perform root-end preparations and filling of canals or significantly increasing the duration of the surgery.