Comparison of Conventional Root Tip Resection with Digitally Guided Resection—An In Vitro Study

Background/Objectives: In oral and maxillofacial surgery, apicoectomy is a standard procedure for treating persistent periapical infections after insufficient conservative treatment. Traditional techniques rely on direct visualization, while navigated methods offer advantages in precision and safety. This in vitro study compared conventional apicoectomy with dynamically guided navigation. The aim was to assess the feasibility, accuracy, and safety of dynamic navigation and to determine whether it reduces complication risks, improves surgical predictability, and minimizes bone loss. Methods: Ten experienced surgeons performed both techniques on custom-designed models. Operation time was assessed, as well as cavity volume, resected root length, incision width and height, and preservation of adjacent structures. Results: The navigated approach demonstrated significantly improved accuracy in root-end resection, with a reduction in access cavity volume (p < 0.001). No significant differences were found in operation time (p = 0.499), resection length (p = 0.054), or incision dimensions (p > 0.05). The risk of damaging adjacent structures was not significantly different between the two methods. Conclusions: Dynamic navigation for apicoectomy can offer an alternative in cases requiring high precision to conventional techniques. However, the routine clinical implementation of dynamic navigation remains limited due to the extensive preoperative planning required. The necessity for additional planning increases complexity, time, and cost.