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 tre-atment. Traditional techniques rely on direct visualization, while navigated methods offer adventages in precision and safety. This in vitro study compared conventional apicoec-tomy 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 sig-nificantly improved accuracy in root-end resection, with a reduction in access cavity volume (p < 0.001) and a more precise resection length (p = 0.049). No significant dif-ferences were found in operation time (p = 0.499) 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 re-quiring high precision to conventional techniques. However, the routine clinical im-plementation of dynamic navigation remains limited due to the extensive preoperative planning required. The necessity for additional planning increases complexity, time and cost.