Mr Influence of clinical and technical parameters on accuracy of guided implant placement. Systematic review and meta-analysis

Aim The aim of the present review was to assess scientific literature on influence of clinical and technical parameters of guided implantation on implant position deviations. Methods Two reviewers conducted electronic searches on Cochrane and PubMed databases and manual search in databases of relevant scientific journals. The date range was limited to from 2009 through 2019.  Results In total  36 publications were included for review and subgroup analysis. Meta-analysis revealed mean deviation of 1.14 mm (95% CI: 1.016, 1.268, SE: 0.064) at implant neck, 1.42 mm (95% CI: 1.275, 1.575, SE: 0.072) at implant apex as well as 0.415 mm (95% CI: 0.317, 0.514, SE: 0.096) of mean vertical error and 3.49° (95% CI: 3.228, 3.756, SE: 0.135) of mean angular error. Significantly lower deviations in one or more measurement points were determined in subgroups of partial edentulism, single implantation per guide, mechanical vertical control, mounted drill design and teeth-supported guides. Conclusion With respect to limitations of the study, it can be concluded that type of edentulism, size of defect, type of vertical control, guide design and type of guide support influence accuracy of computer-assisted guided implantation. Future research should focus on analyzing the advantages of technical parameters of individual static guides in distinct clinical subgroups.