Evaluation of heat generation during implant surgery by conventional and guided approach: a systematic review and meta-analysis.

This systematic review and meta-analysis investigated the difference in heat generated during guided implant surgery compared to freehand surgery. Four databases were searched with keywords for relevant studies.Included studies met the following criteria: in vitro comparison of implant surgery aided by a three-dimensionally printed surgical guide and freehand surgery with external irrigation. Risk-of-bias was assessed using QUIN. Data quantified temperature increases, categorized by device: thermocouple or infrared camera.The search yielded 1750 articles. After removing duplicates and screening, nine were included in the quantitative evaluation (meta-analysis).In the studies using a thermocouple (measurement at 1-3 mm depth), there was no statistically significant difference in temperature increase between the guided and freehand groups (pilot drill 2.0-2.35 mm, P=0.32; 2.8-3.0 mm, P=0.40). The infrared camera studies (pilot drill 2.0-2.35 mm, at 1-3 mm and 3-6 mm depth) showed a statistically significant difference in favour of freehand surgery, particularly at the greater depth: 5.97 °C (95% confidence interval 4.66-7.27 °C) more heat was generated with guided surgery (P<0.001).overall, in vitro studies showed that guided surgery resulted in significantly greater heat generation than freehand surgery, particularly at greater drilling depths.