Accuracy assessment of dynamic computer-aided implant placement: a systematic review and meta-analysis. 2021

Adrià Jorba-García, and Albert González-Barnadas, and Octavi Camps-Font, and Rui Figueiredo, and Eduard Valmaseda-Castellón
Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.

OBJECTIVE To assess the accuracy of dynamic computer-aided implant surgery (dCAIS) systems when used to place dental implants and to compare its accuracy with static computer-aided implant surgery (sCAIS) systems and freehand implant placement. METHODS An electronic search was made to identify all relevant studies reporting on the accuracy of dCAIS systems for dental implant placement. The following PICO question was developed: "In patients or artificial models, is dental implant placement accuracy higher when dCAIS systems are used in comparison with sCAIS systems or with freehand placement? The main outcome variable was angular deviation between the central axes of the planned and final position of the implant. The data were extracted in descriptive tables, and a meta-analysis of single means was performed in order to estimate the deviations for each variable using a random-effects model. RESULTS Out of 904 potential articles, the 24 selected assessed 9 different dynamic navigation systems. The mean angular and entry 3D global deviations for clinical studies were 3.68° (95% CI: 3.61 to 3.74; I2 = 99.4%) and 1.03 mm (95% CI: 1.01 to 1.04; I2 = 82.4%), respectively. Lower deviation values were reported in in vitro studies (mean angular deviation of 2.01° (95% CI: 1.95 to 2.07; I2 = 99.1%) and mean entry 3D global deviation of 0.46 mm (95% CI: 0.44 to 0.48 ; I2 = 98.5%). No significant differences were found between the different dCAIS systems. These systems were significantly more accurate than sCAIS systems (mean difference (MD): -0.86°; 95% CI: -1.35 to -0.36) and freehand implant placement (MD: -4.33°; 95% CI: -5.40 to -3.25). CONCLUSIONS dCAIS systems allow highly accurate implant placement with a mean angular of less than 4°. However, a 2-mm safety margin should be applied, since deviations of more than 1 mm were observed. dCAIS systems increase the implant placement accuracy when compared with freehand implant placement and also seem to slightly decrease the angular deviation in comparison with sCAIS systems. CONCLUSIONS The use of dCAIS could reduce the rate of complications since it allows a highly accurate implant placement.

UI MeSH Term Description Entries
D003201 Computers Programmable electronic devices designed to accept data, perform prescribed mathematical and logical operations at high speed, and display the results of these operations. Calculators, Programmable,Computer Hardware,Computers, Digital,Hardware, Computer,Calculator, Programmable,Computer,Computer, Digital,Digital Computer,Digital Computers,Programmable Calculator,Programmable Calculators
D003758 Dental Implantation, Endosseous Insertion of an implant into the bone of the mandible or maxilla. The implant has an exposed head which protrudes through the mucosa and is a prosthodontic abutment. Dental Implantation, Osseointegrated,Endosseous Dental Implant Therapy,Endosseous Implantation,Osseointegrated Dental Implantation,Endosseous Dental Implantation,Implantation, Endosseous,Implantation, Endosseous Dental,Implantation, Osseointegrated Dental
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000072662 Margins of Excision The edges of tissue removed in a surgery for assessment of the effectiveness of a surgical procedure in achieving the local control of a neoplasm and the adequacy of tumor removal. When the margin is negative or not involved by tumor (e.g., CANCER) it suggests all of the tumor has been removed by the surgery. Negative Surgical Margins,Positive Surgical Margins,Resection Margin,Surgical Margins,Tumor-Free Margins,Excision Margin,Excision Margins,Margin, Resection,Margin, Surgical,Margin, Tumor-Free,Margins, Resection,Margins, Surgical,Margins, Tumor-Free,Negative Surgical Margin,Positive Surgical Margin,Resection Margins,Surgical Margin,Surgical Margin, Negative,Surgical Margin, Positive,Surgical Margins, Negative,Surgical Margins, Positive,Tumor Free Margins,Tumor-Free Margin
D015921 Dental Implants Biocompatible materials placed into (endosseous) or onto (subperiosteal) the jawbone to support a crown, bridge, or artificial tooth, or to stabilize a diseased tooth. Dental Implants, Mini,Dental Prosthesis, Surgical,Implants, Dental,Dental Implant,Dental Prostheses, Surgical,Implant, Dental,Prostheses, Surgical Dental,Prosthesis, Surgical Dental,Surgical Dental Prostheses,Surgical Dental Prosthesis,Dental Implant, Mini,Mini Dental Implant,Mini Dental Implants
D017076 Computer-Aided Design The use of computers for designing and/or manufacturing of anything, including drugs, surgical procedures, orthotics, and prosthetics. CAD-CAM,Computer-Aided Manufacturing,Computer-Assisted Design,Computer-Assisted Manufacturing,Computer Aided Design,Computer Aided Manufacturing,Computer Assisted Design,Computer Assisted Manufacturing,Computer-Aided Designs,Computer-Assisted Designs,Design, Computer-Aided,Design, Computer-Assisted,Designs, Computer-Aided,Designs, Computer-Assisted,Manufacturing, Computer-Aided,Manufacturing, Computer-Assisted
D054893 Cone-Beam Computed Tomography Computed tomography modalities which use a cone or pyramid-shaped beam of radiation. CAT Scan, Cone-Beam,Cone-Beam CT,Tomography, Cone-Beam Computed,Tomography, Volume Computed,CT Scan, Cone-Beam,Cone-Beam Computer-Assisted Tomography,Cone-Beam Computerized Tomography,Volume CT,Volume Computed Tomography,Volumetric CT,Volumetric Computed Tomography,CAT Scan, Cone Beam,CAT Scans, Cone-Beam,CT Scan, Cone Beam,CT Scans, Cone-Beam,CT, Cone-Beam,CT, Volume,CT, Volumetric,Computed Tomography, Cone-Beam,Computed Tomography, Volume,Computed Tomography, Volumetric,Computer-Assisted Tomography, Cone-Beam,Computerized Tomography, Cone-Beam,Cone Beam CT,Cone Beam Computed Tomography,Cone Beam Computer Assisted Tomography,Cone Beam Computerized Tomography,Cone-Beam CAT Scan,Cone-Beam CAT Scans,Cone-Beam CT Scan,Cone-Beam CT Scans,Scan, Cone-Beam CAT,Scan, Cone-Beam CT,Scans, Cone-Beam CAT,Scans, Cone-Beam CT,Tomography, Cone Beam Computed,Tomography, Cone-Beam Computer-Assisted,Tomography, Cone-Beam Computerized,Tomography, Volumetric Computed
D025321 Surgery, Computer-Assisted Surgical procedures conducted with the aid of computers. Used in various types of surgery for implant placement and instrument guidance. Image-guided surgery interactively combines prior CT scans or MRI images with real-time video. Computer-Assisted Surgery,Image-Guided Surgery,Surgery, Image-Guided,Surgical Navigation,Computer-Aided Surgery,Computer Aided Surgery,Computer Assisted Surgery,Computer-Aided Surgeries,Computer-Assisted Surgeries,Image Guided Surgery,Image-Guided Surgeries,Navigation, Surgical,Surgeries, Computer-Aided,Surgeries, Computer-Assisted,Surgeries, Image-Guided,Surgery, Computer Assisted,Surgery, Computer-Aided,Surgery, Image Guided

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