Patient‐reported outcome measures comparing static computer‐aided implant surgery and conventional implant surgery for single‐tooth replacement: A randomized controlled trial

Abstract

Objective: To compare static computer-aided implant surgery (s-CAIS) and conventional implant surgery (CIS) for single-tooth replacement in posterior sites in terms of patient-reported outcome measures (PROMs).Methods: Forty patients were divided into two groups for treatment with s-CAIS (Test) and CIS (Control). Patients' anxiety level was measured using the modified dental anxiety score before implant surgery. After surgery, patients completed two questionnaires for 7 days. The first questionnaire assessed pain level using a visual analog scale (VAS) and the incident rate of pain using a 5-point Likert scale; analgesic intake was also recorded. The second questionnaire investigated patients' oral health-related quality of life (OHRQoL) including postoperative symptoms, oral function, and daily activity. The difference between data was compared at significance level (α = 0.05).Results: There was no statistically significant difference in pretreatment dental anxiety level, postoperative pain scores, and OHRQoL between treatment groups.Overall, mild or moderate dental anxiety was reported by 70% and 20% of patients, respectively. Pain score was significantly reduced by postoperative Day 3 in the test group and Day 4 in the control group, compared with baseline. Both groups significant reduced analgesic intake by postoperative Day 5. Most OHRQoL-related complaints subsided approximately 3 days after surgery. Conclusions:Overall, PROMs between s-CAIS and CIS were not significantly different for the single-tooth implant surgery in the posterior area. Postoperative symptoms after implant surgery still inevitably occurred, reflecting the normal process of oral wound healing.

Can computer‐assisted implant surgery improve clinical outcomes and reduce the frequency and intensity of complications in implant dentistry? A critical review

“…Sancho‐Puchades et al 43 suggested some influence of a “novelty effect” of CAIS on patients' presurgical expectations, as they found that the majority of patients favored the CAIS approach even without having prior experience of implant surgery (CAIS preferred by 83% vs conventional by 6% of patients). However, when a more detailed assessment of presurgical expectations was conducted by Engkawong et al 8 (ie, anticipated symptoms duration and intensity) and Kunavisarut et al 9 (ie, Modified Dental Anxiety Score), no statistically significant differences were found between the expectations of patients scheduled for CAIS or conventional implant placement.…”

“…Five RCTs and one small case‐control study reported short‐term postoperative PROs/PRE adequately for collective analysis. Three RCTs 8,9,43 utilized a VAS of 1‐10 to record pain and swelling among other outcomes but did not find any statistically significant difference in any major postoperative PROs. A small case‐control study (n = 24/41 implants) assessing the same outcomes did not attempt statistical analysis 16 .…”

“…In most cases, the heterogeneity of the data allowed only collective qualitative analysis. In the case of postsurgical PROs of pain originating from the first week of healing, a meta‐analysis was conducted on three studies 8,9,43 . The meta‐analysis was conducted using the software RevMan version 5.4 (Review Manager, the Cochrane Collaboration, 2020).…”

“…22,28 Noncomparative studies often reported high levels of "satisfaction" using descriptive questionnaires 19,22,42 ; such conclusions cannot, however, be extrapolated beyond the limits of each individual study. Five RCTs 8,9,29,36,43 with a total of 282 patients (conventional freehand, n = 117; CAIS, n = 166), one small case-control study, 16 and one cross-sectional survey, 42 have assessed different aspects of PROs and PRE between patients with s-CAIS/d-CAIS and conventional placement controls. Furthermore, one RCT compared PROs between partially and fully guided CAIS, 28 and another between CAIS with immediate and delayed loading.…”

“…found a trend marginally above statistical significance (P = .07) for surgery duration to be shorter with conventional placement (70.3 ± 47.08 minutes) than with s-CAIS (89.70 ± 45.75 Meta analysis of three studies9,10,43 for daily postsurgical pain reported by patients after static computer-assisted implant surgery (s-CAIS) only, compared with those of freehand (FH) implant placement. SD, standard deviation minutes).…”