Comparison of the accuracy/precision among guided (static), manual, and dynamic navigation in dental implant surgery: a systematic review and meta-analysis.

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Oral and maxillofacial surgery Pub Date : 2025-10-10 DOI:10.1007/s10006-025-01462-z

Filipe Castro, Pedro Pereira, Carlos Falcão-Costa, Artur Falcão, Juliana Campos Hasse Fernandes, Gustavo Vicentis Oliveira Fernandes, José-Vicente Rios

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Abstract

Objective: To assess whether dynamic navigation (dCAIS) has greater accuracy/precision and less discrepancy in parallelism compared to guided (static, sCAIS) and free-hand (FH) surgery in Implantology.

Materials and methods: A search was conducted across six databases using specific key terms. Randomized controlled trials (RCTs), retrospective or prospective clinical studies published within the last 10 years (2014-2024) were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool. A meta-analysis using a random-effects model was employed. The heterogeneity analysis was conducted using Cochran's Q-test and Higgins' I² statistic.

Results: Thirteen articles were included. A total of 554 patients and 687 implants were enrolled, with 215 using the FH system, 195 using sCAIS, and 277 using dCAIS. The meta-analysis compared the following: (1) dCAIS vs. sCAIS; (2) dCAIS vs. FH; (3) sCAIS vs. FH. The first group had a mean difference of -0.08 mm, with a substantial heterogeneity (I² = 52%) and no statistically significant difference (p = 0.08); the second presented a mean difference of -0.48 mm, high heterogeneity (I²=89%), and a statistically significant better accuracy for dCAIS than FH (p < 0.01); the last comparison found a mean difference of -0.62 mm, with a considerable heterogeneity (I²=84%), and sCAIS showing statistically significantly better accuracy than the FH approach (p < 0.01).

Conclusions: Using CAIS (dCAIS or sCAIS) substantially improved accuracy compared to the FH approach, with no statistically significant difference between dCAIS and sCAIS.

Clinical relevance: The findings support the use of CAIS for improved implant accuracy and precision compared to FH techniques.

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引导（静态）、手动和动态导航在种植牙手术中的准确性/精密度比较：系统回顾和荟萃分析。

目的：评价动态导航（dCAIS）与引导（静态、sCAIS）和徒手（FH）手术相比，是否具有更高的准确性/精密度和更少的平行度差异。材料和方法：使用特定的关键术语在六个数据库中进行搜索。纳入了最近10年（2014-2024年）发表的随机对照试验（rct）、回顾性或前瞻性临床研究。使用乔安娜布里格斯研究所关键评估工具评估偏倚风险。采用随机效应模型进行meta分析。异质性分析采用Cochran’s q检验和Higgins’I2统计量。结果：纳入13篇文章。共有554名患者和687个植入物入组，其中215人使用FH系统，195人使用sCAIS， 277人使用dCAIS。meta分析比较如下：(1)dCAIS与sCAIS；(2) dCAIS vs. FH；(3) sCAIS vs. FH。第一组平均差异为-0.08 mm，异质性显著（I²= 52%），差异无统计学意义（p = 0.08）；第二种方法的平均差异为-0.48 mm，异质性高（I²=89%），dCAIS的准确性优于FH (p)。结论：使用CAIS （dCAIS或sCAIS）比FH方法显著提高了准确性，dCAIS和sCAIS之间无统计学差异。临床意义：与FH技术相比，研究结果支持使用CAIS提高种植体的准确性和精度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Oral and maxillofacial surgery

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