The accuracy of implant placement with computer-guided surgery in partially edentulous patients and possible influencing factors: A systematic review and meta-analysis

  • Putra Ramadhan Hardani
    Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Japan Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Indonesia
  • Yoda Nobuhiro
    Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Japan
  • Astuti Eha Renwi
    Department of Dentomaxillofacial Radiology, Faculty of Dental Medicine, Universitas Airlangga, Indonesia
  • Sasaki Keiichi
    Division of Advanced Prosthetic Dentistry, Tohoku University Graduate School of Dentistry, Japan

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Abstract

<p>Purpose: To review the current clinical studies regarding the accuracy of implant computer-guided surgery in partially edentulous patients and investigate potential influencing factors.</p><p>Study selection: Electronic searches on the PubMed and Cochrane Central Register of Controlled Trials databases, and subsequent manual searches were performed. Two reviewers selected the studies following our inclusion and exclusion criteria. Qualitative review and meta-analysis of the implant placement accuracy were performed to analyze potential influencing factors. Angular deviation, coronal deviation, apical deviation, and depth deviation were evaluated as the accuracy outcomes.</p><p>Results: Eighteen studies were included in this systematic review, including six randomized controlled trials, nine prospective studies, and three retrospective clinical studies. A total of 1317 implants placed in 642 partially edentulous patients were reviewed. Eight studies were evaluated using meta-analysis. Fully guided surgery showed statistically higher accuracy in angular (P <0.001), coronal (P <0.001), and apical deviation (P <0.05) compared with pilot-drill guided surgery. A statistically significant difference (P <0.001) was also observed in coronal deviation between the bounded edentulous (BES) and distal extension spaces (DES). A significantly lower angular deviation (P <0.001) was found in implants placed using computer-aided design/computer-aided manufacturing (CAD/CAM) compared to the conventional surgical guides.</p><p>Conclusion: The edentulous space type, surgical guide manufacturing procedure, and guided surgery protocol can influence the accuracy of computer-guided surgery in partially edentulous patients. Higher accuracy was found when the implants were placed in BES, with CAD/CAM manufactured surgical guides, using a fully guided surgery protocol.</p>

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