Comparison of implantation accuracy among different navigated approaches: A systematic review and network meta-analysis

Int J Oral Maxillofac Implants. 2023 Nov 1;0(0):1-33. doi: 10.11607/jomi.10381. Online ahead of print.

Abstract

Purpose: Dental implants are a common method for the treatment of tooth loss, and its accuracy directly affects forward efficacy and stability. This study compared the accuracy of different modalities of dental implant placement (dynamic navigation [DN], fully guided [FG] static navigation, partially guided [PG] static navigation, and free handed [FH]) through a network meta-analysis.

Materials and methods: This study followed the Preferred Reporting Items for Meta-Analyses (PRISMA) guidelines and conducted an electronic literature search (Inception-Oct 2, 2022). The comparison of implant accuracy in all the included randomized controlled trials (RCTs) conformed to at least one of the following: deviation at the crown of the implant, deviation at the apical portion of the implant, or angular deviation of the implant.

Results: Twenty-six articles were included for the qualitative analysis (17 RCTs; 3 prospective studies; 6 retrospective studies), and 17 RCTs of which were included for network meta-analysis. The data included in this study had high consistency, and the funnel plot showed that the articles had low publication bias. Compared with FH, FG and DN had higher accuracy in coronal deviation (P<0.05), and FG, DN, and PG had higher accuracy in apical deviation and angular deviation (P<0.05). According to the SUCRA value, FG had the highest accuracy in coronal deviation, while DN had the highest accuracy in apical deviation and angular deviation.

Conclusions: According to the results of this literature review, the accuracy of DN, FG, and PG were higher than those of FH. DN showed the highest accuracy in terms of apical deviation and angular deviation. FG had the best control over the coronal deviation. There was no statistical difference between DN and FG in terms of accuracy. Given the limitations of the current study, further validation is required in the future.