Accuracy of Static Computer-Assisted Implant Surgery in Full- Arches: A Systematic Review of Clinical Studies with Meta- Analysis.

Abstract

Purpose: In full arches, what is the accuracy of dental implants placed by means of static computer-assisted implant surgery (s-CAIS)?

Materials and methods: Two independent and calibrated reviewers selected studies based on pre-defined eligibility criteria and extracted data on study-, population-, intervention- and outcome (accuracy) characteristics. Risk of bias and the quality of evidence assessments of the included articles were performed by an independent and blinded reviewer. The meta-analysis was conducted using the random- effects model at a 5% significance level.

Results: Thirty (5 RCTs, 9 CCTs and 16 Case Series) studies were included. Overall, 2,056 implants distributed among arches in 416 patients (males n=161; females n=188; unclear n = 67) were assessed. Random-effects meta-analysis revealed statistically significant mean horizontal linear distortions at the implant neck and apex levels of 1.18mm (95% CI: 1.00 - 1.35) (p<0.001) and 1.46mm (95% CI: 1.22 - 1.69) (p<0.001), respectively, significant mean vertical linear distortion at implant depth level of 0.58mm (95% CI: 0.18 - 0.98) (p=0.113) and significant mean angular distortion of 3.65° (95% CI: 2.97 - 4.33) (p<0.001). Accuracy did not differ significantly between maxilla and mandible at all parameters assessed (p>0.05).

Conclusions: The accuracy of s-CAIS in full arches is within a clinically acceptable range and a 2-mm ho rizontal and 1-mm vertical safety margin should always be respected at planning.

Practical implications: A safety margin of 2 mm horizontally and 1 mm vertically in the planning for implant placement can ensure better results in full arches with reabsorbed bone.