Computer-Guided Surgery for Dental Implant Placement: A Systematic Review
Abstract
:1. Introduction
Objectives
2. Materials and Methods
2.1. Eligibility Criteria
2.2. Sources of Information and Search
Study Selection and Data Collection
2.3. Risk of Bias Assessment
2.4. Quality of Evidence
2.5. Planned Methods of Analysis and Additional Analysis
3. Results
3.1. Study Selection
3.2. Quality of Evidence
3.3. Risk of within-Study Bias
3.4. Risk of Bias among Studies
3.5. Results of Individual Studies
3.6. Summary of Results
3.6.1. Global Deviation
- Coronal global deviation (CGD)When measuring the overall deviation, i.e., in 3D, between the crown of planned and placed implants in 4 studies [19,21,22,23], it was observed that the least accurate surgery was freehand surgery (1.82 mm) [23] and the most accurate was fully guided surgery (0.73 mm) [21], showing statistically significant differences.
- Apical global deviation (AGD)At the apical level the global deviation, i.e., in 3D, between the apex of the planned and placed implants was also measured in 5 studies [19,20,21,22,23], and it was found that the least accurate surgery was freehand surgery (2.43 mm) [23] and the most accurate was half-guided surgery (0.93 mm) [19], with statistically significant differences.
3.6.2. Vertical Plane
- Coronal vertical deviation (CVD)
- Apical vertical deviation (AVD)When calculating the vertical distance between the apex of planned and placed implants in 3 trials [19,21,22], the same values were obtained as for coronal vertical deviation, with freehand surgery being the least accurate (1 mm) [22] and fully guided surgery the most accurate (0.43 mm) [21], but the differences were not statistically significant in this case.
3.6.3. Mesio-Distal Axis
- Coronal mesio-distal deviation (CMDD)Measuring the distance between the crowns of planned and placed implants in the mesio-distal direction in 2 studies [19,22], implants placed through freehand surgery (0.6 mm) showed the lowest accuracy, [22] and the highest accuracy was observed for implants placed via both fully guided surgery [22] and half-guided surgery [19] (0.3 mm in both cases), the differences being statistically significant.
- Apical Mesio-Distal Deviation (AMDD)When measuring the distance between planned and mesio-distally placed implant apexes in 2 trials [19,22], it was found that the least accurate surgery was freehand surgery (1.2 mm) [22] and the most accurate was half-guided surgery (0.43 mm) [19], the differences also being statistically significant.
3.6.4. Bucco-Lingual Axis
- Coronal bucco-lingual deviation (CBLD)The bucco-lingual distance between the crown of planned and placed implants was measured in 2 studies [19,22] and the maximum deviation was found in freehand surgery (0.8 mm) [19] and the minimum in fully guided surgery (0.4 mm) [22]. Therefore, freehand surgery proved to be the least accurate and fully guided surgery the most accurate, but it should be noted that although differences were observed, they were not statistically significant in this case.
- Apical bucco-lingual deviation (ABLD)When measuring the bucco-lingual distance between planned and placed implant apexes in 2 studies [19,22], the lowest accuracy was observed in freehand surgery (1.38 mm) [19] and the highest in half-guided surgery (0.53 mm) [19], but the differences were not statistically significant, as in the previous case.
3.6.5. Angular Deviation
3.6.6. Lateral Direction
- Coronal lateral deviation (CLD)When measuring the distance in lateral direction between the crown of planned and placed implants in three studies [19,21,24], it was observed that the least accurate surgery was freehand surgery (1.7 mm) [24] and the most accurate was fully guided surgery (0.55 mm) [21], with statistically significant differences.
- Apical lateral deviation (ALD)The distance in lateral direction between the apexes of planned and placed implants was measured in three studies [19,21,24] and the highest value was observed when performing freehand surgery (2.51 mm) [24], while the lowest value was found in implants placed with half-guided surgery (0.73 mm) [19]. Therefore, when measuring this parameter, freehand surgery was the least accurate and half-guided surgery the most accurate, with the results showing statistically significant differences.
3.6.7. Voxel Overlap
4. Discussion
4.1. Summary of Evidence
4.1.1. Accuracy of Guided Surgery vs. Freehand Surgery
4.1.2. Accuracy of Different Guided Surgery Techniques
4.1.3. Advantages and Disadvantages
4.1.4. Indications for Guided Surgery
4.1.5. Limitations of Guided Surgery
4.1.6. Complications
4.2. Limitations of This Review
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Author/Year | Comparisons Made |
---|---|
Younes et al., 2019 [20] | Freehand vs. pilot-guided and fully guided. |
Younes et al., 2018 [21] | Freehand vs. pilot-guided and fully guided. |
Smitkarn et al., 2019 [22] | Freehand vs. fully guided. |
Varga et al., 2020 [23] | Freehand vs. pilot-guided, half-guided and fully guided. |
Aydemir and Arisan, 2020 [24] | Freehand vs. dynamic guided. |
Chen et al., 2018 [19] | Freehand vs. half-guided. |
Author/Year | Type of Study | Compared Techniques | Measurements (mm, Degrees and Percentage) | N Teeth Rehabilitated/Patient | Edentulism |
---|---|---|---|---|---|
Younes et al., 2019 [20] | RCT | FH vs. PD vs. FG | Global deviation (AGD) | N = ≥2 | Class III |
Younes et al., 2018 [21] | RCT | FH vs. PD vs. FG | Global deviation (CGD and AGD) Vertical plane (CVD and AVD) Lateral direction (CLD and ALD) | N = ≥2 | Class III |
Smitkarn et al., 2019 [22] | RCT | FG vs. FH | Global deviation (CGD and AGD) Vertical plane (CVD and AVD) Mesio-distal axis (CMDD and AMDD) Bucco-lingual axis (CBLD and ABLD) Deviation of the axes (DA) (°) | N = 44 patients 1 implant N = 8 patients 2 implants | Class III |
Varga et al., 2020 [23] | RCT | FH vs. PD vs. HG vs. FG | Global deviation (CGD and AGD) Deviation of the axes (AD) (°) VO (%) | - | - |
Aydemir and Arisan., 2020 [24] | RCT | DG vs. FH | Lateral direction (CLD and ALD) Deviation of the axes (AD) (°) | N = ≥2 | Class I |
Chen et al., 2018 [19] | CCT | HG vs. FH | Global deviation (CGD and AGD) Vertical plane (AVD) Mesio-distal axis (CMDD and AMDD) Bucco-lingual axis (CBLD and ABLD) Deviation of the axes (AD) (°) Lateral direction (CLD and ALD) | N = ≥2 | Class III |
Types of Surgery | Measurements (mm and Degrees) | Author/Year |
---|---|---|
Aydemir et al., 2020 [24] | ||
Freehand Surgery (FH) (N = 192) | AD (°) | 10.04 |
CLD | 1.7 | |
ALD | 2.51 | |
Dynamic Guided Surgery (DG) (N = 43) | AD (°) | 5.59 |
CLD | 1.01 | |
ALD | 1.83 |
Types of Surgery | Measurements in Millimeters (mm), Degrees (°) and Percentages (%) | Author/Year | |||||
---|---|---|---|---|---|---|---|
Younes et al., 2019 [20] | Younes et al., 2018 [21] | Smitkarn et al., 2019 [22] | Varga et al., 2020 [23] | Chen et al., 2018 [19] | |||
Freehand Surgery (FH) (N = 192) | CGD | 1.45 | 1.5 | 1.82 | 1.43 | ||
AGD | 2.11 | 2.11 | 2.1 | 2.43 | 2.2 | ||
CVD | 0.53 | 1 | |||||
AVD | 0.5 | 1 | 0.6 | ||||
CMDD | 0.6 | 0.4 | |||||
AMDD | 1.2 | 1.12 | |||||
CBLD | 0.5 | 0.8 | |||||
ABLD | 1 | 1.38 | |||||
AD (°) | 6.9 | 7.03 | 6.78 | ||||
CLD | 1.27 | 1.09 | |||||
ALD | 1.97 | 2.04 | |||||
VO (%) | 40.57 | ||||||
Static Guided Surgery (SG) (N = 284) | Fully Guided Surgery (FG) (N = 124) | CGD | 0.73 | 1 | 1.4 | ||
AGD | 0.97 | 0.97 | 1.3 | 1.59 | |||
CVD | 0.43 | 0.7 | |||||
AVD | 0.43 | 0.7 | |||||
CMDD | 0.3 | ||||||
AMDD | 0.6 | ||||||
CBLD | 0.4 | ||||||
ABLD | 0.7 | ||||||
AD (°) | 3.1 | 3.04 | |||||
CLD | 0.55 | ||||||
ALD | 0.81 | ||||||
VO (%) | 58.82 | ||||||
Half-Guided Surgery (HG) (N = 63) | CGD | 1.37 | 0.85 | ||||
AGD | 1.59 | 0.93 | |||||
AVD | 0.5 | ||||||
CMDD | 0.3 | ||||||
AMDD | 0.43 | ||||||
CBLD | 0.42 | ||||||
ABLD | 0.53 | ||||||
AD (°) | 4.3 | 3.11 | |||||
CLD | 0.62 | ||||||
ALD | 0.73 | ||||||
VO (%) | 60.37 | ||||||
Pilot Drill-Guided Surgery (PD) (N = 97) | CGD | 1.12 | 1.57 | ||||
AGD | 1.43 | 1.43 | 1.86 | ||||
CVD | 0.68 | ||||||
AVD | 0.68 | ||||||
AD (°) | 5.71 | ||||||
CLD | 0.79 | ||||||
ALD | 1.14 | ||||||
VO (%) | 55.8 |
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Araujo-Corchado, E.; Pardal-Peláez, B. Computer-Guided Surgery for Dental Implant Placement: A Systematic Review. Prosthesis 2022, 4, 540-553. https://doi.org/10.3390/prosthesis4040044
Araujo-Corchado E, Pardal-Peláez B. Computer-Guided Surgery for Dental Implant Placement: A Systematic Review. Prosthesis. 2022; 4(4):540-553. https://doi.org/10.3390/prosthesis4040044
Chicago/Turabian StyleAraujo-Corchado, Elena, and Beatriz Pardal-Peláez. 2022. "Computer-Guided Surgery for Dental Implant Placement: A Systematic Review" Prosthesis 4, no. 4: 540-553. https://doi.org/10.3390/prosthesis4040044