The accuracy of static computer-aided implant surgery: A systematic review and meta-analysis

Objectives: To assess the literature on the accuracy of static computer-assisted implant surgery in implant dentistry. Materials and Methods: Electronic and manual literature searches were conducted to collect information about the accuracy of static computer-assisted implant systems. Meta-regression analysis was performed to summarise the accuracy studies. Results: From a total of 372 articles. 20 studies, one randomised controlled trial (RCT), eight uncontrolled retrospective studies and 11 uncontrolled prospective studies were selected for inclusion for qualitative synthesis. A total of 2,238 implants in 471 patients that had been placed using static guides were available for review. The meta-analysis of the accuracy (20 clinical) revealed a total mean error of 1.2 mm (1.04 mm to 1.44 mm) at the entry point, 1.4 mm (1.28 mm to 1.58 mm) at the apical point and deviation of 3.5 degrees(3.0 degrees to 3.96 degrees). There was a significant difference in accuracy in favour of partial edentulous comparing to full edentulous cases. Conclusion: Different levels of quantity and quality of evidence were available for static computer-aided implant surgery (s-CAIS). Based on the present systematic review and its limitations, it can be concluded that the accuracy of static computer-aided implant surgery is within the clinically acceptable range in the majority of clinical situations. However, a safety marge of at least 2 mm should be respected. A lack of homogeneity was found in techniques adopted between the different authors and the general study designs.