Accuracy of Dynamic Computer-Assisted Implant Placement: A Systematic Review and Meta-Analysis of Clinical and In Vitro Studies

Abstract

The aim of this systematic review and meta-analysis is to analyze the accuracy of implant placement using computer-assisted dynamic navigation procedures. An electronic literature search was carried out, supplemented by a manual search. The literature search was completed in June 2020. The results of in vitro and clinical studies were recorded separately from each other. For inclusion in the review, the studies had to examine at least the prosthetically relevant parameters for angle deviation, as well as global deviation or lateral deviation at the platform of the implant. Sixteen of 320 articles were included in the investigation: nine in vitro and seven clinical studies. The meta-analysis showed values of 4.1° for the clinical studies (95% CI, 3.12–5.10) and 3.7° for the in vitro studies (95% CI, 2.31–5.10) in terms of the angle deviation. The global deviation at the implant apex of the implant was 1.00 mm for the clinical studies (95% CI, 0.83–1.16) and 0.91 mm for the in vitro studies (95% CI, 0.60–1.12). These values indicate no significant difference between the clinical and in vitro studies. The results of this systematic review show a clinical accuracy of dynamic computer-assisted navigation that is comparable to that of static navigation. However, the dynamic navigation systems show a great heterogeneity that must be taken into account. Moreover, currently there are few clinical data available. Therefore, further investigations into the practicability of dynamic navigation seem necessary.

Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial

“…The evaluation of the angular deviation in the present study showed a mean deviation of 2.7° (95% CI, 2.2°–3.3°). These values showed a similar precision compared to the majority of studies published to date [ 31 ]. The angular deviations reported in these studies were between 3.68° (95% CI, 3.61°–3.74°) [ 43 ] and 4.22° (95% CI, 2.74°–5.68°) [ 44 ].…”

“…Previously published data on the accuracy of dynamic navigation were analyzed in three systematic reviews. On average, the coronal 3D deviation at the implant shoulder was between 1.00 mm (95% CI 0.83, 1.16 mm) and 1.11 mm (95% CI 0.96, 1.26 mm) [ 31 , 43 , 44 ]. The implant exit point is particularly important for prosthetically predictable results.…”

“…A systematic review of clinical studies on the accuracy of dynamic computer-aided navigation showed comparable results to those of static navigation. However, individual dynamic navigation systems show great heterogeneity, which must be considered [ 31 ]. We may assume that further development of surgical procedures through virtual and augmented reality technologies will increase the quality of implantological care [ 32 ].…”

Does the macro design of an implant affect the accuracy of template-guided implantation? A prospective clinical study

“…Template-guided implant placement has proven to be a reliable static computer-assisted surgical method. A further dynamic procedure is real-time navigation [2,3].…”

Autonomous Robotic Surgery for Immediately Loaded Implant-Supported Maxillary Full-Arch Prosthesis: A Case Report

“…Both DICOM files were imported to the robotic surgery verification system, and this registration process was further performed. In addition, the errors between the planned and placed implant positions were measured, as previously described in detail [ 20 , 21 ]. Based on the central axis of the planned and placed implants, the accuracy data showed the distance deviation in mm, including the global coronal deviation, vertical coronal deviation, lateral coronal deviation, global apical deviation, vertical apical deviation, and lateral apical deviation, respectively ( Figure 7 ).…”