EC Dental Science

Objectives: We examined the literature on dynamic navigation (DN) for minimally invasive and predictable access, and compared its accuracy, dentin preservation, efficiency, and complications with those of the freehand and static approaches.

Materials and Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020) guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched (2013-2023) using terms related to DN and guided endodontics. Due to substantial methodological heterogeneity, a narrative synthesis was performed. We evaluated risk of bias using QUIN, RoB 2, and ROBINS-I.

Results: We included 15 studies: seven in vitro, five clinical, and three comparatives. The mean linear deviation was 0.28-0.47, 0.39-0.56, and 0.67-1.20 mm for DN, static guidance, and freehand, respectively. Mean angular deviation was 1.9-3.2°, 2.1-3.8°, and 4.5-7.0° for DN, static guidance, and freehand, respectively. DN was associated with a better dentin preservation than the freehand technique, and it was comparable to static guidance. Preparation time was broadly similar across methods, with static approaches having slightly longer times.

Conclusion: DN is associated with a high accuracy, improved dentin preservation relative to freehand access, and intra-operative adaptability that aligns with minimally invasive endodontic principles.

Clinical Relevance: Cost, training requirements, and the limited number of robust clinical studies restrict routine DN use. Larger, randomized controlled trials and standardized outcome reporting are required to confirm long-term clinical and patient-centered benefits.

Keywords: Dynamic Navigation; Guided Endodontics; Minimally Invasive Endodontics; CBCT; Root Canal Access; Dentin Preservation

1. Maxfield L and Crane JS. “Leishmaniasis”. Stat Pearls [International. Treasure Island, Florida (2025).
2. JanSelvapandiyan A., et al. “An update on clinical and pathogenic spectra of leishmaniasis”. Expert Reviews in Molecular Medicine 27 (2025): e27.
3. Ejazi SA., et al. “Editorial: Leishmaniasis and immunity: challenges, advances and future perspective”. Frontiers in Immunology 16 (2025): 1666020.
4. Haghayeghi K., et al. “Primary cutaneous gamma-delta T-cell lymphoma masquerading as leukemia cutis in a patient recently diagnosed with small lymphocytic lymphoma: Clues to the diagnosis”. Journal of Cutaneous Pathology 12 (2022): 1015-1020.
5. Hirata C., et al. “Primary cutaneous gamma-delta T-cell lymphoma initially diagnosed as subcutaneous panniculitis-like T-cell lymphoma with dermatomyositis”. Dermatopathology (Basel)2 (2022): 143-147.
6. Jahromi AS., et al. “Knowledge, attitudes, and practices toward cutaneous leishmaniasis as a neglected tropical disease among the general population: a systematic review and meta-analysis”. Journal of Epidemiology and Global Health 1 (2025): 97.
7. El Moctar A., et al. “Ongoing presence of Leishmania major cutaneous leishmaniasis in Mauritania, 2016-2024”. BMC Infectious Diseases 1 (2025): 596.
8. Majoor A., et al. “Leishmaniases: Strategies in treatment development”. Parasite 32 (2025): 18.
9. Duarte AGS., et al. “An updated systematic review with meta-analysis and meta-regression of the factors associated with human visceral leishmaniasis in the Americas”. Infectious Diseases of Poverty 1 (2025): 4.
10. Heras-Mosteiro J., et al. “Interventions for Old World cutaneous leishmaniasis”. Cochrane Database of Systematic Reviews 12 (2017): CD005067.
11. Image 1 Courtesy: Springer link.
12. Image 2 Courtesy: Pathology outlines.