2 F ROM PAGE ON E Endo Tribune U.S. Edition | April 27–30, 2022 ENDO TRIBUNE PUBLISHER & CHAIRMAN Torsten Oemus t.oemus@dental-tribune.com PRESIDENT & CHIEF EXECUTIVE OFFICER Eric Seid e.seid@dental-tribune.com GROUP EDITOR Kristine Colker k.colker@dental-tribune.com MANAGING EDITOR Fred Michmershuizen f.michmershuizen@dental-tribune.com PRODUCT/ACCOUNT MANAGER Humberto Estrada h.estrada@dental-tribune.com PRODUCT/ACCOUNT MANAGER Maria Kaiser m.kaiser@dental-tribune.com CLIENT RELATIONS COORDINATOR Lee Colquhoun l.colquhoun@dental-tribune.com ACCOUNTING COORDINATOR Nirmala Singh n.singh@dental-tribune.com Tribune America LLC 118-35 Queens Blvd, Ste 400 Forest Hills, NY 11375 (212) 244-7181 Published by Tribune America © 2022 Tribune America, LLC All rights reserved. Endo Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please contact Group Editor Kristine Colker at k.colker@dental-tribune.com. Endo Tribune cannot assume responsibility for the validity of product claims or for typographical errors. The publisher also does not assume responsibility for product names or statements made by advertisers. Opinions expressed by authors are their own and may not reflect those of Endo Tribune or Tribune America. EDITORIAL BOARD Dr. Frederic Barnett Dr. Roman Borczyk Dr. L. Stephen Buchanan Dr. Gary B. Carr Prof. Dr. Arnaldo Castellucci Dr. Unni Endal Dr. Frnando Goldberg Dr. Vladimir Gorokhovsky Dr. Fabio G.M. Gorni Dr. James L. Gutmann Dr. William “Ben” Johnson Dr. Anne L. Koch Dr. Sergio Kuttler Dr. John T. McSpadden Dr. Richard E. Mounce Dr. John Nusstein Dr. Ove A. Peters Dr. David B. Rosenberg Dr. Clifford J. Ruddle Dr. William P. Saunders Dr. Kenneth S. Serota Dr. Asgeir Sigurdsson Dr. Yoshitsugu Terauchi Dr. John D. West Corrections Endo Tribune strives to maintain the utmost accuracy in its news and clinical reports. If you find a factual error or content that requires clarification, please report the details to Managing Editor Fred Michmershuizen at f.michmershuizen@dental-tribune.com. Endodontists attend a lecture presented by Dr. John J. Stropko at a previous AAE annual session. At AAE22, meeting attendees can partake in as many as 28.5 hours of C.E. offerings, which are divided into numerous educational tracks. Photo/Endo Tribune file photo “ ENDO, Page 1 exhibitors, AAE staff and guests) is re- quired to provide proof of vaccination or proof of a negative test taken within 48 hours of arrival. As of press time, it was not determined whether masks would be required, but AAE recommends all attendees carry a face covering at all times during the meeting, as masking requirements may change. Onsite testing is available for a fee. Now that the vaxing and masking is covered, let’s get back to the endo, shall we? The centerpiece of any AAE event, of course, is the education. Offerings in- clude hands-on sessions, lectures, panel discussions and presentations offered right on the show floor. This year, meeting attendees can par- take in as many as 28.5 hours of C.E. offerings. The educational tracks are as follows: Clinical/Ethical Dilemmas (“Prickly Situations”); Interdisciplinary; Non-Surgical Root Canal Therapy; Pain; Practice Management/Teamwork; Surgi- cal Root Canal Therapy; and Submitted Presentations. Check your meeting guide or visit aae.org/aae22 for a complete list- ing of course titles, speakers, times and locations. For those unable to attend in-person, select session livestreams are available virtually. “The AAE provides its members with the highest quality of continuing den- tal education programs and chances to hear from industry experts about new technologies, the latest in safety and health measures around COVID-19, pain management without the use of opioids and more,” meeting organizers said in a press release issued before the event commenced. Also not to be missed here at AAE is the General Session with Keynote Speaker Colin O’Brady, taking place Wednesday from 4:30 to 6 p.m. in the North Ball- room, where all of the main events at AAE22 will also take place. O’Brady completed the world’s first solo, unsupported and unaided crossing of Antarctica and is regarded as one of the world’s best endurance athletes and an expert on mindset. O’Brady will share his inspirational, thought-provoking sto- ry and will tell audience members what he has learned about the human mind and how to unlock human potential. Other events of note include the Presi- dent’s Breakfast, featuring AAE President Dr. Alan S. Law, taking place from 8 to 9:30 a.m. Thursday. The General Assem- bly is from 8:30 to 9:45 a.m. Friday, and the Edgar D. Coolidge Awards Brunch is from 10:15 a.m. to noon Saturday. Also not to be missed is the exhibit hall, located on Level 3, where company reps are eager to talk to you about their offerings. Show hours are Wednesday from 9:30 a.m. to 4:30 p.m., Thursday from 9:30 a.m. to 6:30 p.m. and Friday from 9:45 a.m. to 5:30 p.m. All during the meeting, attendees can participate in the Endo Wellness Chal- lenge, sponsored by EdgeEndo. Simply use your smartphone or fitness tracking device to count your steps and earn priz- es, not to mention bragging rights. So now that you have your “marching orders,” it’s time for you to go out and ex- plore! Enjoy the meeting! “ FOUNDATION, Page 1 ing pool of outstanding academicians to become academic leaders in dental in- stitutions. Endodontic education drives the specialty forward, and supporting endodontists leadership positions raises the profile of endodontics within institutions. in “An opportunity to influence educa- tion and research, combined with ADEA’s dedication to providing the support and resources of future specialists in our field, serves as the foundation of our pledge,” Dr. Daryl Dudum, co-CEO and co-founder, Endo1 Partners, said. According to the foundation, these awards will enable a growing pool of out- standing residents and academicians to achieve new heights. About the Foundation for Endodontics Founded in 1966 as the philanthropic arm of the AAE, the Foundation for End- odontics (a 501(c)3 charity) encourages and raises capital investment necessary to sustain and further develop the spe- cialty. Over the years, both its mission and activities have evolved into four ar- eas: research, education, access to care and development. By focusing on these four concentrations, the foundation as- sists members of AAE in the pursuit of excellence in their field and furthers the vision of supporting endodontists in their efforts to save natural teeth when- ever possible. The foundation supports every accred- ited endodontic program in the United States and Canada, and offers funding to educators, residents and departments. For more information, visit foundation. aae.org. (Source: Foundation for Endodontics)

4 A A E N EWS Endo Tribune U.S. Edition | April 27–30, 2022 AAE survey reveals Americans eating fewer sweets, resolving to prioritize oral health Fifty-six percent of Americans plan to drink fewer sugary drinks, cut back on candy/sweets or reduce coffee or tea consumption. Photo/@konarska, freeimages.com AD It’s no surprise that cases of cracked teeth and dental-related injuries have risen throughout the pandemic — and it may be due in part to pandemic-related stress wreaking havoc on oral health. According to a November 2021 survey fielded by the American Association of Endodontists, 81 percent of American adults wish they had taken better care of their natural teeth. More than half (55 percent) wish their parent(s) had in- stilled better oral hygiene habits when they were younger, and 43 percent admit tooth pain or oral health issues negative- ly affects their productivity or ability to focus. In other findings, more than a quarter (26 percent) of Americans feel others would find them more attractive and about one in six (16 percent) feel they would have a more active dating life if they took better care of their teeth. However, there is hope: 76 percent intend to prioritize their oral health in 2022. And they’re not just thinking of themselves, as nearly seven in 10 (69 per- cent) would consider giving a toothbrush (electric or manual) to someone for a gift. Other findings: • 66 percent plan to brush or floss their teeth more often. • 56 percent plan to drink fewer sugary drinks, cut back on candy/sweets or re- duce coffee or tea consumption. • 36 percent want to improve the ap- pearance of their teeth. • 19 percent will resolve to quit or re- duce teeth grinding. AAE President Dr. Alan S. Law said: “Major tooth pain can strike at any time or place, and it’s critically important that patients seek treatment from a skilled dental specialist right away when this happens. AAE’s recently improved on- line directory can help patients more eas- ily connect with an endodontist in their area when they need relief from tooth pain, want to save their natural teeth via root canal treatment or need to receive immediate care for other dental-related emergencies.” The AAE commissioned Atomik Re- search (a division of 4media group) to conduct an online survey of 1,004 Amer- ican adults. The makeup of the sample is statistically representative of the U.S. population based on the national census data regarding gender, age and geograph- ical regions. The margin of error for the overall sam- ple (N=1,004) fell within +/- 3 percentage points with a confidence interval of 95 percent. Fieldwork took place between October 14-18, 2021. Atomik Research is an independent market research agency. (Source: American Association of Endodontists)

6 E X H I BI TOR S Endo Tribune U.S. Edition | April 27–30, 2022 Introducing Triton, the all-in-one irrigation solution By Brasseler USA Staff Despite the introduction of several unique devices to aid in endodontic ir- rigation, the fact remains that NaOCl is buffered when it comes into contact with inorganic dentinal debris. EDTA aids in dentinal debris dissolu- tion, but it also buffers NaOCl, so clini- cians must use high volumes of multiple irrigation solutions, which requires ad- ditional steps, irrigants, syringes and needles. But now there is a solution with Tri- ton, according to Brasseler USA. Triton is a patent pending all-in-one irrigation solution that allows for synergistic and simultaneous dissolution of organic and inorganic debris. According to the company, Triton per- mits the clinician to use lower volumes of irrigation solution and ensures maxi- mum clinical efficiency. Unlike tradi- tional irrigants or other 2:1 solutions, Tri- ton works differently by avoiding the use of EDTA and CHX altogether. By using a lower concentration of Na- OCl and a patent-pending proprietary Testimonial and images/Provided by Brasseler USA blend of surfactants and gentle chelating agents, Triton is the first irrigant to deliv- er all of the benefits of NaOCl, EDTA and CHX in a single-step all-in-one irrigation solution. The non-NaOCl components in Triton proactively dissolve the dentinal debris, allowing for a lower concentra- tion of NaOCl (also included in Triton) to be exposed to organic debris without as Here in Phoenix Visit booth No. 713 to learn more about Brasseler USA’s latest innovations and to take advantage of exclusive AAE22 show specials. much buffering. With Triton, the company asserts, irrigation is no irritation at all. PORTRAY brings 3-D tomo to intraoral imaging By Surround Medical Systems Staff Intraoral tomosynthesis is now available to dentists nationwide. The PORTRAY System is the first stationary intraoral tomosynthesis X-ray imaging device to receive 510K premarket clear- ance from the FDA and is the result of two decades of discovery, innovation and development. With the power of 3-D tomo, dentists can obtain more clinical information, resulting in more actionable diagnoses. The power of intraoral tomosynthesis imaging has been optimized to give the dentist more information about teeth, root conditions and bony structures. The PORTRAY System has been de- signed to fit into a space similar to that of a conventional 2-D intraoral imaging device. It deploys a faster sensor that acquires images from an array of focal spots. The PORTRAY System uses a complex algorithm to create a volume of images that can be scrolled through in 0.5 mm “slices,” revealing internal tooth condi- The PORTRAY System is the first stationary intraoral tomosynthesis X-ray imaging device to receive 510K premarket clearance from the FDA. Photo/Provided by Surround Medical Systems tions such as fractures and caries. With the power of 2-D synthetic imaging, the image can also be rotated to open inter- proximal contacts. Here in Phoenix To learn more about 3-D tomo, the PORTRAY Sys- tem and Surround Medical Systems, stop by the booth, No. 124. The dentist will not have difficulty reading the 3-D tomo X-rays: If you can read a 2-D X-ray, you can read a PORTRAY System X-ray. Workflows for technical staff are simi- lar to conventional 2-D intraoral imag- ing. Tomosynthesis has been long used in other fields, such as mammography, with greater clinical effect than that of 2-D. 3-D tomo should not be confused with CBCT, as it deploys an entirely different imaging method and generates intraoral images with greater resolution. The PORTRAY System is offered by Sur- round Medical Systems. Dr. Enrique Platin, retired professor at The Adams School of Dentistry, Uni- versity of North Carolina at Chapel Hill, said in a statement: “In 70 years, this is the first viable X-ray device that changes how clinicians see dental structures on intraoral images.”

8 E X H I BI TOR S Endo Tribune U.S. Edition | April 27–30, 2022 X-Guide is the first navigation system approved by FDA for navigated endodontics By X-Nav Technologies Staff The X-Guide® Dynamic Navigation system has gained worldwide popular- ity for delivering surgeons the ability to perform more accurate and precise dental implant procedures compared to freehand surgery, according to X-Nav Technologies, the company behind the technology. In fact, more than 175,000 dental im- plants have been surgically placed using the X-Guide system. Now, patients and dentists can benefit from achieving more precise and mini- mally invasive access to tooth structures needing endodontic treatment — such as calcified canals, apicoectomies and mo- lar access of affected teeth. “X-Guide dynamic navigation is an ex- tremely accurate solution to a common endodontic challenge: calcified root ca- nal systems,” said L. Stephen Buchanan, DDS, FICD, FACD, of Santa Barbara, Ca- lif. “With X-Guide, I can perform mini- mally invasive root canal therapy (RCT) with much more predictability and less stress.” Using the X-Guide’s patented X-Point technology, the dentist gains a live view of the patient’s 3-D anatomy to guide drill movements during surgery to pre- cisely navigate their drill to an exact ac- cess location for more effective endodon- tic procedures. New tools in the X-Guide software make navigation easy to integrate into the endodontic workflow, such as the virtual Prep feature for planning and following an ideal drill path, integration with high-speed handpieces and X-Mark virtual registration for small, medium and large field-of-view CBCTs. Combining 3-D imaging with X-Guide navigation allows dentists to locate and access endodontic tooth structures more precisely, which is useful to: • achieve less invasive access and prep of calcified and hidden canals. • minimize damage to anatomical structures. • preserve tooth structure. • reduce intra-operative imaging and save time. • perform minimally invasive apicoec- tomy and root-end access. A look at the X-Guide software’s new virtual Prep path tool. the calcified tooth, it may also be used to reduce structural weakening of teeth through minimally invasive endodontic procedures,” said Dr. Charles Maupin, DDS, of Lubbock, Texas. Several studies have been published showing the evidence-based clinical ad- vantages of navigated endodontics using the X-Guide system. “The X-Guide Dynamic Navigation Sys- tem has not only provided a solution to According to a study conducted by the University of Maryland School of Den- Using the X-Guide’s patented X-Point technology, dentists can gain a live view of a patient’s 3-D anatomy to guide drill movements during surgery to precisely navigate their drill to an exact access location for more effective endodontic procedures. Photos/Provided by X-Nav Technologies Here in Phoenix To learn more about the X-Guide Dynamic Surgical Navigation for single implants, full arch reconstruc- tion and endodontics, stop by the booth, No. 526, or go online to www.X-NavTech.com. tistry: “The dynamic navigation system was more accurate and more efficient in root-end resection in a cadaver model than the freehand technique. The dy- namic navigation system has the poten- tial to be a safe and reliable technological addition to endodontic microsurgery.”1 Dr. Frederico Martinho, DDS, M.Sc., PhD, and clinical associate professor, said: “Our recent studies with X-Guide focused on minimally invasive access cavity, post removal, locating calcified canals and endodontic microsurgery. It has the potential to improve accuracy and reduce surgical time and operator mishaps. “Both the endodontic residents and I were able to quickly master the technol- ogy — the learning curve was not steep for novel or experienced endodontists.” “As X-Guide surgical navigation be- came an integral part of dental implant surgery, it was clear that expanding ac- cess to our technology could improve provider capabilities and patient experi- ences with endodontic procedures. I’m proud of our talented team of clinical and engineering masterminds for being able to deliver the benefits of surgical navigation to more dental professionals,” said Edward Marandola, president, CEO and co-founder of X-Nav Technologies. To read more about the benefits of X- Guide Dynamic Surgical Navigation for single implants, full arch reconstruction and endodontics, visit www.X-NavTech. com. Reference 1. Accuracy and efficiency of guided root-end resec- tion using a dynamic navigation system: a human cadaver study. O Dianat, A Nosrat, B Mostoufi, J B Price, S Gupta, F C Martinho. PMID: 33368371, DOI: 10.1111/iej.13466.

10 E X H I BI TOR S Endo Tribune U.S. Edition | April 27–30, 2022 PlanB and MIE: The new look of exceptional endodontics By L . Stephen Buchanan, DDS, FACD, FICD, Dipl. ABE It has been interesting times lately in the field of endodontics. In many ways, our new materials, tools and techniques have radically improved clinicians’ effi- ciency and efficacy — the best examples being the introduction of rotary negotia- tion, single-file shaping and 3-D obtura- tion of bioceramic sealers. For me, the really intriguing aspects of endodontics revolve around MIE (mini- mally invasive endodontics) and EIP (enhancing irrigation performance). MIE — because we can do better than simply succeed in our RCT, only to lose the tooth five to 15 years later because of structural failure. EIP — because it’s one thing to cut a smaller shape in a root canal, but it’s an entirely different thing to kill all the bacteria and digest all pulp remnants while working through smaller passage- ways. What is clearly needed are new con- cepts, tools and techniques specifically designed to empower us to meet these two complementary challenges. The potential payoff is improving our long- term success while re-establishing RCT as a single-visit procedure. What is MIE? Minimally invasive end- odontics means different things to dif- ferent clinicians. Our most talented endodontists have been competing for some time to see who can do a per- fect RCT through the smallest access opening(s). However, all of us involved in this MIE quest have experienced failures because of the much, much greater dif- ficulties attendant to this approach. For me, MIE isn’t about doing root ca- nals through impossible “Ninja” access cavities, although I love a challenge as much as the next endodontist. My definition of MIE is saving as much tooth structure as is practical without re- ducing the probabilities of success. MIE is not saving so much tooth structure that the tooth is lost because of inadequate treatment. How do we do this? MIE preparations begin with the use of small, guided ac- cess burs and are completed with rotary instruments having maximum flute di- ameter limitations (Figs. 1 and 2) to com- pletely control cervical enlargement. Holistically considered MIE treatment requires this preparation be completely disinfected and all pulp tissue remnants be digested — preferably in a single visit. Timing is the most critical variable in- fluencing technological advancement, Fig. 1 (far left). These two posterior teeth with severe canal curvatures are treated with miniKUT Rotary Files (PlanB Dental). Note the multiple lateral portals of exit cleaned and filled despite the minimalistic shaping. Case courtesy of Dr. Charles Maupin. Fig. 2 (near left). This lower molar was completely negotiated and shaped with just a single 15-.03 and 15-.05 miniKUT Rotary File, preserving dentin coronally as well as all the abrupt canal curves. Case courtesy of Dr. J.T. Crepps. Figs. 3a-d (below left). This severely pulpitic #18 was treated in a single visit, using a miniKUT 15-.03 to negotiate and shape the mesial canals and a 20-.05 miniKUT file to accomplish the same in the distal canal. After instrumentation was completed (in the presence of EDTA), the tooth was staged and catheterized for PulpSucker irrigation, after which 75 ml of 8 percent NaOCl was vacuum-drawn through the root canal system during 18 minutes of hands-off PS procedure time. Note the never-touched 7 mm long mid-mesial canal with its own lateral portal of exit and the delta pattern of filled lateral canals in the apical part of the distal root. Most important: Note the complete osseous regeneration of peri-radic- ular bone in less than a year. Case by Dr. L. Stephen Buchanan Here in Phoenix To learn more about PlanB and such products as the PulpSucker and the miniKUT Rotary Files, stop by the booth, No. 125. and this truism is evident in the rapid strides being made in both MIE and ir- rigation procedures. These advances are synergistic because MIE begs for better irrigation methods while enhanced irri- gation efficacy make cutting tooth struc- ture less and less important. To accomplish this in a cost-effective manner, we have created a multi-cannu- lar, negative pressure irrigation system we named PulpSucker (by PlanB Dental). Early clinical trials of PulpSucker, used in single-visit treatment of severely in- flamed pulpitis cases, are returning very promising results as reported by patients on the night of the procedure. The coolest thing about PS irrigation? PulpSucker’s elegant design optimizes irrigation outcomes through established scientific protocols. Instead of requiring an $80K machine, PS irrigation continu- ously, simultaneously delivers effective concentrations of NaOCl into all primary canals, cleaning the smallest lateral re- cesses in less than 15 hands-off minutes (Figs. 3a-d). (Author’s note: PlanB Dental is a startup dedicated to empowering clinicians to achieve exceptional MIE RCT results.)

12 E X H I BI TOR S Endo Tribune U.S. Edition | April 27–30, 2022 Keep your chin up, neck straight, eyes forward with Infinity VUE By Designs for Vision Staff Designs for Vision has several new and innovative products, including the Infin- ity VUE, Panoramic Field and REVEAL. Designed to provide a straightforward approach to ergonomics, Infinity VUE loupes are available from Designs for Vi- sion in 3.0x and 3.5x magnification. Infinity VUE (Vision Up Ergonomics) keeps your chin up, your neck straight and your eyes forward while viewing the magnified oral cavity. You need to try these loupes on to see (and feel) the dif- ference in your posture. The new patented Panoramic Field Loupes (US pat. 8928975B2) represent the most significant advancement in telescope design in more than 100 years, according to the company. The viewable areas are twice as large as prismatic ex- panded field designed loupes and up to five times greater than Galilean loupes. Field Panoramic loupes provide unprecedented field of view, clarity, defi- nition and color, according to the com- pany. Designs for Vision is also offering REVEAL (US pat. 10215977B1), which pro- vides hands-free fluorescence enhanced theragnosis (FET). REVEAL supplies the visual information to support deci- sion making and facilitate proper treat- ment options in cariology, oral hygiene, periodontology-implantology and re- storative dentistry. Another Designs for Vision product is the patented (US pat. 8,851,709 & RE46,463) intuitive response technology of the Micro IR HDi headlight. The pat- ented IR feature allows you to operate the headlight with hands-free operation. Infinity VUE loupes, one of many new innovations available from Designs for Vision, are designed to help improve posture. Photo/Provided by Designs for Vision Onboard biometrics sense the position of the headlight to turn the light on when you are working and turn the light off when you look up. Designs for Vision’s WireLess head- lights free you from being tethered to a battery pack. The simple modular designs uncouple the headlights from a specific frame or single pair of loupes. The com- pact design of the LED DayLite WireLess headlights is independent of any frame/ loupes. Here in Phoenix You can see the Visible Difference yourself by visit- ing Designs for Vision at booth No. 719, or you can contact the company to arrange a visit in your office by calling (800) 345-4009 or emailing info@dvimail. com. Products you trust at prices you like Stop by booth No. 433 to learn more By Predictable Surgical Technologies Staff Predictable Surgical Technologies is dedicated to supplying high-quality sup- plies for professionals in the dental in- dustry. The company’s goal is to provide its customers with the products they de- sire while minimizing their costs. Predictable Surgical Technologies of- fers more than 500 manufacturers with access to more than 600,000 products. It has been in business for almost 20 years and has established business relation- ships with more than 220 manufacturers throughout the world. The company asserts that it works to help you save money while using the same products you know and trust. Here in Phoenix To learn more about Predictable Surgical Technolo- gies, stop by the booth, No. 433. Surgical Predictable Technologies wants you to know it looks forward to serving you and your practice with a wide range of quality products at reason- able prices. You can give the company a call at (866) 586-1211, and staff will be happy to an- swer any questions, or you can go online to pstshop.com.

14 E X H I BI TOR S Endo Tribune U.S. Edition | April 27–30, 2022 Dynamic navigation: Invention, innovation, revelation, revolution (Photo/Provided by ClaroNav) By Dr Kenneth S. Serota, DDS, MMSc Here in Phoenix laser/sound/fluid dynamic irrigation. lows the planned pathway. Fifty years ago, Apollo 11, after a com- puter-guided voyage of 250,000 miles, orbited the moon. Neil Armstrong, avoiding house-sized boulders and dan- gerously steep inclines, was able to safely fly the lunar lander onto Tranquility Base assisted by AGC computers. In the field of endodontics, the accu- racy of dento-osseous freehand naviga- tion has been heightened by the mag- nification and illumination capabilities of microscopes and the spatial plane coordinates of cone-beam computed tomography. Minimally invasive access penetration and osteotomies have miti- gated unnecessary structural removal. The preservation of the tooth framework ensures its capacity to sustain adverse functional stresses. The fundamental concern with the use of freehand navigation is that, at its best, the axis angulation can be as off as much as 2.0 mm, which is inconsistent with di- minished structure removal. To learn more about ClaroNav’s dynamic navigation, stop by the booth, No. 827. 3-D printers and intraoral scanners have definitively altered the procedural landscape of endodontics. Static naviga- tion stents are used to enhance the accu- racy of access preparation and trephine dedicated microsurgery. Although stents are an effective evo- lution in procedural protocols, there are limitations to their use. Stents are cum- bersome and bulky. Their use can be restricted by insufficient interocclusal space in posterior and anterior regions and minimal space for microsurgical access. Their fit can be compromised by fabrication inadequacies, and of greatest significance, the predetermined pathway is unalterable. Dynamic navigation is used exten- sively in neurosurgery, spinal and ortho- pedic surgery. Endodontics is embracing this technology as an integral part of a new triad: CBCT, dynamic navigation and Estimates place the global population older than age 65 at 615 million. Years of dentate and periodontal disease can have an impact on the pulp, the periapex and peri-radicular tissues. With longevity will come the need for targeted accuracy as increasing numbers of complex end- odontic procedures occur. Dynamic navigation facilitates real- time computer guidance technology us- ing a CBCT dataset. This is analogous to the use of GPS and satellite navigation. Trace and Place (TaP), which has been developed by the Canadian company ClaroNav, eliminates the need for a fi- ducial stent, thus reducing the workflow time as well as the need for an extra registration scan. This also eliminates the concern of needing the fiducial posi- tioned in exactly the same position dur- ing the surgery as it was during the scan. A stereoscopic camera tracks tags con- nected to the patient’s jaw and to the instrument specific to the procedure. A navigation screen shows the instru- ment’s movement on the CBCT as it fol- Dynamic navigation is invaluable in tracking MB2 canals, middle mesial ca- nals and C-shaped canals. Removal of fibre posts is simplified, the use of piezo- tomes facilitates guided cortical window procedures, and 6mm trephines can cre- ate a minimal crypt and resect the apex. It has been demonstrated in vitro that dynamic navigation technology can be used to track ultrasonic tips. Innovation in dentistry occurs when there is a willingness to explore and improve both diagnosis and treatment. The challenge is to cohesively marry the equipment and materials to new soft- ware applications. Safer and less invasive protocols are the direction of dentistry’s future. Dy- namic navigation is proving to be the pilot. Improvement in stereoscopic cam- eras, the resolution of computer screens, optical markers and the reference array to the patient and the instrumentation used will herald an unprecedented level of accuracy in all patient-centric dental procedures.