Carlos Aznar Portoles, DDS, MSc
Santpoort-Zuid, Netherlands
4:35 p.m.
Saturday, June 27, 2020
International Academy of Endodontics, Annual Meeting
The Scottsdale Princess Resort
Scottsdale, Arizona, USA
“Dynamic Guided Surgery"
Endodontic Microsurgery is a treatment option for teeth with persistent periapical pathology. Modern microsurgical techniques developed after the introduction of the Dental Operating Microscope have shown to provide better results when compared to traditional ones.

The use of CBCT imaging helps the clinician to reach a more accurate diagnosis and more effective treatment planning. Recently, computer-aided techniques based on the use of three-dimensional (3D) cone-beam computed tomography have been developed in different disciplines in medicine and dentistry to also guide the clinician during treatment. The use of these techniques has many potential benefits:

  • Less invasive treatment
  • Higher accuracy than free-hand techniques
  • Lower risk of iatrogenic damage
  • Reduced chair time, less morbidity and faster recovery
  • Increased ergonomy

To date, 2 different approaches to computer-aided techniques have been described: static and dynamic navigation.

The static techniques use a pre-designed guide, which is placed on the patient’s mouth during treatment. These guides, usually made of laboratory resin, contain one or several openings designed for the use of drills/trephines, which allow a precise osteotomy.

In the dynamic techniques, the patient’s jaw is registered on the CBCT image, providing real-time guidance to the surgeon. Thanks to this live feedback on the screen, the surgeon can verify the position and angulation of the drill. It also allows him to change the treatment plan if necessary while always the following guidance from the computer.

During this presentation, I will describe the use of dynamic surgical navigation in different situations during endodontic microsurgery.

Topics: Dynamic Surgical Navigation in Endodontic Microsurgery
Learning Objectives: 
  1. Describe Dynamic Surgical Navigation
  2. List the different applications of Dynamical Surgical Navigation in Endodontic Microsurgery
  3. Describe how this technique is used in different clinical situations
Affiliations:  Specialist member ESE (European Society of Endodontics), Member of AEDE (Spanish Endodontic Society) and NVVE (Dutch Endodontic Society).


About the Presenter: Dr. Carlos Aznar Portoles obtained his dental degree in 2004 from Universitat Internacional de Catalunya, Barcelona, Spain. In 2009 he completed a Master Program in Endodontics at the same university. After moving to The Netherlands, he obtained a Postgraduate Certificate in Endodontics in 2014 (ACTA, Amsterdam). He is the author of several endodontic-related articles and lectures regularly at national and international meetings. Amongst his articles are “Dehydration Induces Cracking in Root Dentin Irrespective of Instrumentation: A Two-Dimensional Study”; “Bioactivity potential of endo sequence BC RRM putty”; and “A Central Incisor with 4 Independent Root Canals: A Case Report” in the JOE 2015. Dr. Portoles maintains a private office in Haarlem, The Netherlands, which is limited to endodontics and endodontic microsurgery.