Inflammatory response followed by significant peri-implant bone resorption suggested 28 days ligation is sufficient to successfully induce peri-implantitis in the current mice model. This model might open a new avenue to study the pathogenesis and mechanism of peri-implantitis.

Computer‐assisted implant surgery (CAIS), either static or dynamic, is well documented to significantly improve the accuracy of implant placement. Whether the increased accuracy leads to a corresponding improvement in clinical outcomes has not yet been systematically investigated. The aim of this critical review was to investigate whether the use of CAIS can lead to reduction of complications as well as improved clinical and patient‐reported outcomes (PROs) when compared with conventional freehand implant surgery. A comprehensive online search was conducted to identify studies where implants were installed with static computer‐assisted implant surgery (s‐CAIS)or dynamic computer‐assisted implant surgery(d‐CAIS) or combinations of the two, either compared with conventional free‐hand implant placement or not. Seventy‐seven studies were finally included in qualitative analysis, while data from three studies assessing postsurgical pain were suitable for a meta‐analysis. Only a small number of the available studies were comparative. The current evidence does not suggest any difference with regard to intraoperative complications, immediate postsurgical healing, osseointegration success, and survival of implants placed with CAIS or freehand protocols. Intraoperative and early healing events as reported by patients in randomized clinical trials (RCTs) did not differ significantly between CAIS used with flap elevation and conventional implant placement. There is limited evidence that increased accuracy of placement with CAIS is correlated with superior esthetic outcomes. Use of CAIS does not significantly reduce the length of surgeries in cases of single implants and partially edentulous patients, although there appears to be a more favorable impact in fully edentulous patients. Although CAIS alone does not seem to improve healing and the clinical and PRO, to the extent that it can increase the utilization of flapless surgery and predictability of immediacy protocols, its use may indirectly lead to substantial improvements in all of the above parameters.

Background Different designs of surgical drilling systems have been developed for the purpose of static Computer‐Assisted Implant Surgery (sCAIS), but there is at present little understanding of how design principles affect the accuracy of implant placement. Purpose The aim of this in vitro study was to compare the accuracy of implant placement among five drilling systems of sCAIS in a controlled experimental setting. Materials and Methods Twenty‐five 3D printed models with two edentulous bilateral premolar spaces were allocated to five different drilling systems: group A: sleeve‐in‐sleeve, group B: sleeve‐in‐sleeve with self‐locking, group C: mounted sleeve‐on‐drill, group D: integrated sleeve‐on‐drill with metal sleeve in the guide, group E: integrated sleeve‐on‐drill without metal sleeve. Models were scanned with CBCT and optical scanner. All implants were digitally planned and 10 implants placed with sCAIS in each group. Postoperative 3D deviation of placed vs planned position was measured by means of platform, apex and angular deviation. Data was analyzed using Kruskal‐Wallis test (P ≤ .05). Pairwise comparisons were tested with Dunn's test with adjusted P values. Results The overall platform deviation ranged from 0.42 ± 0.12 mm (group B) to 1.18 ± 0.19 mm (group C). The overall apex deviation ranged from 0.76 ± 0.22 mm (group B) to 1.95 ± 0.48 mm (group D). The overall angular deviation ranged from 2.50 ± 0.89 degree (group B) to 5.30 ± 1.04 degree (group E). Group A and B showed significantly less angular deviation than groups D and E (P < .05). There was no statistically significant differences in all parameters between group A and B, as well as between group D and E (P > .05). Conclusions Significant differences were found with regards to accuracy among the five sCAIS systems tested, suggesting that the drilling protocol, the devices used and the design principles of the guides could influence the accuracy of implant placement.

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