Accuracy assessment of dynamic navigation during implant placement: A systematic review and meta-analysis of clinical studies in the last 10 years

Xinbo Yu; Baoxin Tao; Feng Wang; Yiqun Wu

doi:10.1016/j.jdent.2023.104567

Accuracy assessment of dynamic navigation during implant placement: A systematic review and meta-analysis of clinical studies in the last 10 years

J Dent. 2023 Aug:135:104567. doi: 10.1016/j.jdent.2023.104567. Epub 2023 May 30.

Authors

Xinbo Yu¹, Baoxin Tao¹, Feng Wang², Yiqun Wu³

Affiliations

¹ Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
² Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: diana_wangfeng@aliyun.com.
³ Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China. Electronic address: yiqunwu@hotmail.com.

PMID: 37263412
DOI: 10.1016/j.jdent.2023.104567

Abstract

Objectives: To evaluate the accuracy of dynamic computer-aided implant surgery (dCAIS) and compare it with static computer-aided implant surgery (sCAIS) and freehand implant placement (FH) in partially or fully edentulous patients.

Data: Studies that analyzed the accuracy of dynamic computer-assisted implant surgery in partially or fully edentulous patients.

Sources: This meta-analysis included studies published in English and Mandarin Chinese from January 2013 to February 2023 from MEDLINE/PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CNKI (China National Knowledge Infrastructure).

Study selection: Only clinical studies were included. Accuracy was the primary outcome. Seventeen studies met the inclusion criteria. A total of 2,025 implants were analyzed. Meta-regression was conducted to compare the six different navigation systems. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted as a collective grading of the evidence.

Conclusions: Dynamic navigation is a clinically reliable method for implant placement. Significantly lower angular deviation was observed for dCAIS compared to both sCAIS and FH, while significantly lower global platform and apex deviations were displayed between dCAIS and FH. Overall, dynamic navigation allowed for higher accuracy compared to both sCAIS and FH in a clinical setting; however, additional large sample RCT studies should be conducted, and patient-reported outcome measures (PROMs) reported.

Clinical significance: This systematic review analyzed the accuracy of dynamic computer-assisted implant surgery in partially or fully edentulous patients compared with static navigation. The results demonstrated that dynamic navigation could decrease implant placement angular deviations.

Keywords: Computer-assisted surgery; Dental implants; Evidence-based dentistry; Image-guided surgery; Surgical navigation systems.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, Non-U.S. Gov't

MeSH terms

China
Computer-Aided Design
Cone-Beam Computed Tomography
Dental Implantation, Endosseous / methods
Dental Implants*
Humans
Imaging, Three-Dimensional
Mouth, Edentulous* / surgery
Surgery, Computer-Assisted*

Substances

Dental Implants