Dynamic Implant Surgery—An Accurate Alternative to Stereolithographic Guides—Systematic Review and Meta-Analysis

Abstract

(1) Background: Dynamic guided surgery is a computer-guided freehand technology that allows highly accurate procedures to be carried out in real time through motion-tracking instruments. The aim of this research was to compare the accuracy between dynamic guided surgery (DGS) and alternative implant guidance methods, namely, static guided surgery (SGS) and freehand (FH). (2) Methods: Searches were conducted in the Cochrane and Medline databases to identify randomized controlled clinical trials (RCTs) and prospective and retrospective case series and to answer the following focused question: “What implant guidance tool is more accurate and secure with regard to implant placement surgery?” The implant deviation coefficient was calculated for four different parameters: coronal and apical horizontal, angular, and vertical deviations. Statistical significance was set at a p-value of 0.05 following application of the eligibility criteria. (3) Results: Twenty-five publications were included in this systematic review. The results show a non-significant weighted mean difference (WMD) between the DGS and the SGS in all of the assessed parameters: coronal (n = 4 WMD = 0.02 mm; p = 0.903), angular (n = 4 WMD = −0.62°; p = 0.085), and apical (n = 3 WMD = 0.08 mm; p = 0.401). In terms of vertical deviation, not enough data were available for a meta-analysis. However, no significant differences were found among the techniques (p = 0.820). The WMD between DGS and FH demonstrated significant differences favoring DGS in three parameters as follows: coronal (n = 3 WMD = −0.66 mm; p =< 0.001), angular (n = 3 WMD = −3.52°; p < 0.001), and apical (n = 2 WMD = −0.73 mm; p =< 0.001). No WMD was observed regarding the vertical deviation analysis, but significant differences were seen among the different techniques (p = 0.038). (4) Conclusions: DGS is a valid alternative treatment achieving similar accuracy to SGS. DGS is also more accurate, secure, and precise than the FH method when transferring the presurgical virtual implant plan to the patient.

Accuracy of Dental Implant Placement with Dynamic Navigation—Investigation of the Influence of Two Different Optical Reference Systems: A Randomized Clinical Trial

“…However, it also shows that significant differences can occur even with minor variations in the referencing method. This is also confirmed by studies and comparisons of different navigation systems, some of which have significantly different referencing methods [34,56]. Analogies between individual systems are therefore not appropriate.…”

“…A comparison of studies on static navigation shows it has similar accuracy to dynamically navigated implantation [26,32,33]. Marques-Guasch et al conclude in their meta-analysis that dynamic navigation is a valid alternative treatment that achieves similar accuracy to static navigation [34]. The accuracy of freehand implantation is clearly inferior to that of the other two methods [35,36].…”

Digital planning and bone regenerative technologies: A narrative review

“…The selected articles dealing with digital workflow included mainly planning and surgical protocols related to implant placement in native bone (Al Yafi et al, 2019;Amorfini et al, 2023;Colombo et al, 2017;De Santis et al, 2022;Huang et al, 2022;Jorba-García et al, 2021;Marques-Guasch et al, 2023;Nikoyan & Patel, 2020;Poli et al, 2021;Scolozzi et al, 2023;Siqueira et al, 2020;Tahmaseb et al, 2018;Verhamme et al, 2015;Wismeijer et al, 2018).…”

“…and dynamic (D-CAIS) computer-aided implant surgery. As demonstrated by a series of systematic reviews, computer-aided implant surgery performed significantly better as compared to the freehand approach (Marques-Guasch et al, 2023;Siqueira et al, 2020;Tahmaseb et al, 2018).…”