Potential Deviation Factors Affecting Stereolithographic Surgical Guides: A Systematic Review

Objective: The aim of this study was to review potential deviation factors in stereolithographic surgical guides for dental implantology, warnings, and limitations of the system. Methods: An electronic search in databases EMBASE, the Cochrane Library, and PubMed were conducted by 3 researchers to collect information on the accuracy of static computer-guided implant placement to summarize and analyze the overall accuracy. The latter included a search for correlations between factors such as support (teeth/mucosa/bone), number of templates, use of fixation pins, jaw, template production, guiding system, and guided implant placement in articles related to guided surgery with stereolithographic static systems. Studies published between 2012 and 2017 were reviewed. Results: From 761 identified articles, a total of 24 articles were reviewed, which included 2767 dental implants. Data from studies analysis had shown a mean deviation of 3.08 degrees in angular position, 1.14 at the entry point, and 1.46 at apex position. Involved deviation factors were related to planning, laboratory, and surgical phases. Conclusion: Guided surgery may have a limited precision as technique, which surgeons need to be aware in the planning process. This review suggests some security measures in guided surgery process.