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

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Abstract

Objectives

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.

Materials and 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).

Conclusion

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.

Clinical Relevance

The use of dCAIS could reduce the rate of complications since it allows a highly accurate implant placement.

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Acknowledgements

The authors wish to thank Mary Georgina Hardinge for her English language editing assistance.

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The research was not supported by any source of funding.

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Authors and Affiliations

  1. Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain

    Adrià Jorba-García, Albert González-Barnadas, Octavi Camps-Font, Rui Figueiredo & Eduard Valmaseda-Castellón

  2. IDIBELL Institute, Barcelona, Spain

    Albert González-Barnadas, Octavi Camps-Font, Rui Figueiredo & Eduard Valmaseda-Castellón

  3. Facultat de Medicina i Ciències de la Salut, Campus de Bellvitge, Universitat de Barcelona (UB), Pavelló de Govern, 2a Planta, Despatx 2.9, C/Feixa Llarga s/n, E-08907 L’Hospitalet de Llobregat, Barcelona, Spain

    Rui Figueiredo

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Contributions

Adrià Jorba-García and Albert González-Barnadas: Conception of the review; literature search and data acquisition; article drafting; approval of the final version of the manuscript and agreement to be accountable for all aspects of the work.

Octavi Camps-Font: Conception of the review; analysis and interpretation of the data; critical review of the article; approval of the final version of the manuscript and agreement to be accountable for all aspects of the work.

Rui Figueiredo and Eduard Valmaseda-Castellón: Conception of the review; interpretation of the data; critical review of the article; approval of the final version of the manuscript and agreement to be accountable for all aspects of the work.

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Correspondence to Rui Figueiredo.

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Conflict of interest

The authors have no direct financial or other interests in the products or information mentioned in this paper. Adrià Jorba-Garcia and Albert González-Barnadas declare no conflicts of interest. Dr. Octavi Camps-Font reports grants from Avinent (Santpedor, Spain) and has participated as a sub-investigator in clinical trials sponsored by Mundipharma (Cambridge, UK) and Menarini Richerche (Florence, Italy).

Dr. Rui Figueiredo reports grants, personal fees, and non-financial support from MozoGrau (Valladolid, Spain) and from Avinent (Santpedor, Spain) and personal fees from BioHorizons Iberica (Madrid, Spain), Inibsa Dental (Lliçà de Vall, Spain), Dentsply implants Iberia (Barcelona, Spain), and ADIN Implants (Afula, Israel) outside the submitted work. Dr. Figueiredo has also participated as a principal investigator in a randomized clinical trial sponsored by Mundipharma (Cambridge, UK) and in another clinical trial as a sub-investigator for Menarini Richerche (Florence, Italy). Dr. Eduard Valmaseda-Castellón reports personal fees and non-financial support from MozoGrau (Valladolid, Spain) and from Avinent (Santpedor, Spain) and personal fees from BioHorizons Iberica (Madrid, Spain), Inibsa Dental (Lliçà de Vall, Spain), and Dentsply implants Iberia (Barcelona, Spain) outside the submitted work. In addition, Dr. Valmaseda-Castellón has also participated as a sub-investigator in a randomized clinical trial sponsored by Mundipharma (Cambridge, UK).

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Jorba-García, A., González-Barnadas, A., Camps-Font, O. et al. Accuracy assessment of dynamic computer–aided implant placement: a systematic review and meta-analysis. Clin Oral Invest 25, 2479–2494 (2021). https://doi.org/10.1007/s00784-021-03833-8

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