From Planning to Execution: The Advantage of Real-time Dynamic Navigation in the Extraction of Impacted Mandibular Third Molars

Abstract

Purpose: This study aimed to evaluate the clinical efficacy of applying Real-time Dynamic Navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN will reduce surgical time and minimize the risk of injury to adjacent anatomical structures. Methods: A prospective study was conducted on 160 patients aged between 18 and 37 years old with deep horizontal impaction of the mandibular third molar. Participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized Cone Beam Computed Tomography (CBCT) and Mimics software for accurate localization and segmentation of impacted teeth. Parametric data were analyzed using an independent t-test for intergroup comparisons, with significance set at p < 0.05. Results: The experimental group required an average of 11±1 minutes for preoperative planning using RDN, which was not a requirement for the control group. The setup of the navigation system took an average of 4±1 minutes in the experimental group and 0 minutes in the control group. The experimental group demonstrated a significantly shorter average surgical time of 22 ± 3 minutes compared to the control group's 36 ± 3 minutes. So, the differences preoperative design time, in surgical time, and complication rates between the two groups were statistically significant (p=0.005). Additionally, the RDN group reported no complications related to adjacent tooth damage or nerve injury, whereas the control group noted instances of adjacent tooth damage and lower lip discomfort, suggesting inferior alveolar nerve irritation. Conclusion: Precise, Secure, R eal-time guidance that supports the application of RDN in complicated dental extractions and introduces a new era of oral and maxillofacial surgery.