Objective <p>This study aimed to preliminarily evaluate the precision of a dynamic navigation system (DNS) in guiding a piezoelectric surgical device for the removal of impacted anterior maxillary teeth.</p> Methods <p>Patients with impacted teeth in the anterior maxilla were enrolled in the study. Preoperative cone-beam computed tomography (CBCT) scans were used to digitally plan the osteotomy site and tooth sectioning trajectory within the DNS software. During surgery, a DNS-guided piezoelectric device was applied to perform both the bone flap osteotomy and tooth sectioning. The actual osteotomy field was intraoperatively scanned using an intraoral scanner, and the postoperative osteotomy contours were compared with the preoperative virtual plan to assess surgical accuracy.</p> Results <p>Eleven patients with a total of 12 impacted teeth were included. The mean osteotomy duration was 10.33 ± 3.82&#xa0;min. The average deviation at the boundary apex was 1.17 ± 0.77&#xa0;mm, while the boundary angle and boundary length deviations were 5.90 ± 4.22° and 0.57 ± 0.50&#xa0;mm, respectively. The mean intersection-over-union value for the osteotomy area was 0.81 ± 0.07. Only mild postoperative symptoms were reported, and no significant injury to adjacent anatomical structures occurred.</p> Conclusions <p>These preliminary findings suggest that DNS-guided piezoelectric surgery is a viable approach for extracting impacted anterior maxillary teeth, demonstrating encouraging accuracy and safety.</p> Clinical relevance <p>The integration of dynamic navigation technology with piezoelectric instrumentation provides a minimally invasive and precise method for managing impacted anterior maxillary teeth.</p>