Accuracy of dynamic navigation compared with static navigation for guided endodontic microsurgery: A randomised controlled trial

Objectives: This study aimed to compare the accuracy of static navigation (SN)– and dynamic navigation (DN)–assisted endodontic microsurgery (EMS) in osteotomy and root-end resection. Methods: This prospective, single-blind, randomised clinical trial enrolled 18 patients who met the inclusion criteria and underwent EMS. Osteotomy and root-end resection procedures were performed using either SN or DN systems. Preoperative virtual plans were registered and compared with postoperative cone-beam computed tomography (CBCT) data to quantitatively assess surgical accuracy. The evaluated parameters included start-point deviation (SD), end-point deviation (ED), angular deviation (AD), root-end resection length deviation (RLD), and root-end resection angle deviation (RAD). Results: A total of 18 patients (19 teeth, 20 roots) were included in the study, with 10 patients treated using SN and 8 using DN. Quantitative analysis demonstrated that the SN group exhibited significantly greater deviation in ED compared with the DN group (p = 0.02). No statistically significant differences were observed between the groups for SD, AD, RLD, or RAD (p > 0.05). Conclusion: Both DN- and SN-assisted approaches achieved clinically acceptable accuracy for EMS in osteotomy and root-end resection. DN demonstrated superior accuracy at the surgical endpoint, suggesting a potential advantage in complex cases involving proximity to critical anatomical structures, where precise apical localisation is essential. Clinical significance: These findings provide a scientific basis for optimising and promoting the broader clinical adoption of guided endodontic technologies. © 2026 Elsevier Ltd