Dynamic Navigation System Accuracy in Orthodontic Miniscrew Insertion in the Palatine Vault: A Prospective Single- Arm Clinical Study

Aim: The aim of this study was to evaluate the accuracy of Dynamic Navigation (DN) in miniscrew insertion in the palatine vault by comparing the deviation between planned and placed miniscrew positions. The secondary outcome was to evaluate the correlation between the number of miniscrews inserted and both the accuracy variables and the duration of interventions.
Materials and Methods: Twenty-three subjects were included in the study and each had 2 miniscrews inserted using a DN system (46 miniscrews inserted overall). Pre-operative STL and DICOM files were matched to planned miniscrews insertion and a post-operative CBCT was performed immediately afterwards to measure the deviations between the planned and placed miniscrews, evaluating four variables: Entry-3D, Apex-3D, Apex-vertical and angular deviation. The duration of intervention was also calculated. Descriptive statistics and Pearson correlation coefficient were performed; P-value was set at ≤ 0.05.
Results: The mean Entry-3D deviation was 2.55 mm; the mean Apex-3D deviation was 3.11 mm; the mean Apex-point deviation was 0.87 mm; the mean angular deviation was 8.50°. The mean duration of the intervention was 2:75 min:sec. A statistically significant correlation was found only between the number of surgeries and the duration of the interventions, which decreased over time.
Conclusion: It is possible to conclude that DN is a viable alternative to miniscrew insertion in the palatal vault even if there is a wide deviation range. There is no significant correlation between the accuracy variables and the number of surgeries. In contrast, the duration of the interventions shortens over time.