The accuracy of implant placement with computer-guided surgery in partially edentulous patients and possible influencing factors: A systematic review and meta-analysis

Abstract

Purpose: To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing factors. Study selection: Electronic searches on the PubMed and Cochrane Central Register of Controlled Trials databases, and subsequent manual searches were performed. Two reviewers selected the studies following our inclusion and exclusion criteria. Qualitative review and meta-analysis of the implant placement accuracy were performed to analyze potential influencing factors. Angular deviation, coronal deviation, apical deviation, and depth deviation were evaluated as the accuracy outcomes. Results: Eighteen studies were included in this systematic review, including six randomized controlled trials, nine prospective studies, and three retrospective clinical studies. A total of 1317 implants placed in 642 partially edentulous patients were reviewed. Eight studies were evaluated using meta-analysis. Fully guided surgery showed statistically higher accuracy in angular (P <0.001), coronal (P <0.001), and apical deviation (P <0.05) compared with pilot-drill guided surgery. A statistically significant difference (P <0.001) was also observed in coronal deviation between the bounded edentulous (BES) and distal extension spaces (DES). A significantly lower angular deviation (P <0.001) was found in implants placed using computer-aided design/computer-aided manufacturing (CAD/CAM) compared to the conventional surgical guides. Conclusions: The edentulous space type, surgical guide manufacturing procedure, and guided surgery protocol can influence the accuracy of computer-guided surgery in partially edentulous patients. Higher accuracy was found when the implants were placed in BES, with CAD/CAM manufactured surgical guides, using a fully guided surgery protocol.

Accuracy of routine digitally guided immediate full-arch rehabilitations: an observational analysis of eight patients

“…Also, no clinical studies appear to be available that have systematically investigated the effect of using a pinhole drill guide yet. Despite this lack of available reference data, the observations in this study are well in line with studies that analyzed the effects of the type of guide support on implant placement accuracy 16,30) . In this context, it is also interesting to note that anchoring pins displayed a relatively higher placement accuracy when com-pared to implants.…”

“…Specifically, the indication and patient-individual anatomic preconditions have been reported to affect implant placement accuracy significantly. This effect was mainly attributed to differences in the availability of anatomical structures for landmarking during virtualization and the type of tissues that may be used to support the surgical guide 30,34) . .…”

Accuracy of commercial 3D printers for the fabrication of surgical guides in dental implantology

“…Based on the literature, the error factors can be classified in three categories (i) clinical situation derived factor [8,9], (ii) implant system derived factors [10] and (iii) surgical guide design [11,12] and manufacturing derived factor [13,14]. For example, Putra et al [15] showed in a literature review that guides produced by a conventional method induce a higher angular deviation than a 3D-printed guide.…”

JPR starts 2022 with a new design –Towards a new frontier in prosthodontics–

“…Indeed, cur-rent prosthodontic treatments are closely related to digital dentistry. This issue of JPR contains several topics covering digital technologies, such as digital impression [4] and computer-aided design and manufacturing (CAD/CAM) [5] for digital dentures, implant computer-guided surgery [6] and 3D printing [7]. In addition, a review article by Kishimoto et al on dental applications of artificial intelligence (AI) [8] illustrates the dawning of a new era, in which digital data provide effective diagnosis and suitable treatment planning for future prosthodontic treatments.…”