Department of Periodontology, Catholic University Leuven, Kapucijnenvoer, 33, 3000, Leuven, Belgium.
Clin Oral Implants Res. 2012 Oct;23 Suppl 6:112-23. doi: 10.1111/j.1600-0501.2012.02552.x.
To assess the accuracy of static computer-guided implant placement.
Electronic and manual literature searches were conducted to collect information on the accuracy of static computer-guided implant placement and meta-regression analyses were performed to summarize and analyse 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, guided implant placement.
Nineteen accuracy studies met the inclusion criteria. Meta analysis revealed a mean error of 0.99 mm (ranging from 0 to 6.5 mm) at the entry point and of 1.24 mm (ranging from 0 to 6.9 mm) at the apex. The mean angular deviation was 3.81° (ranging from 0 to 24.9°). Significant differences for all deviation parameters was found for implant-guided placement compared to placement without guidance. Number of templates used was significant, influencing the apical and angular deviation in favour for the single template. Study design and jaw location had no significant effect. Less deviation was found when more fixation pins were used (significant for entry).
Computer-guided implant placement can be accurate, but significant deviations have to be taken into account. Randomized studies are needed to analyse the impact of individual parameters in order to allow optimization of this technique. Moreover, a clear overview on indications and benefits would help the clinicians to find the right candidates.
评估静态计算机引导种植体植入的准确性。
通过电子和手动文献检索收集关于静态计算机引导种植体植入准确性的信息,并进行荟萃回归分析以总结和分析总体准确性。后者包括搜索支持物(牙齿/粘膜/骨)、模板数量、使用固定销、颌骨、模板制作、引导系统、引导种植体植入等因素之间的相关性。
19 项准确性研究符合纳入标准。荟萃分析显示,在入口处的平均误差为 0.99 毫米(范围为 0 至 6.5 毫米),在根尖处的平均误差为 1.24 毫米(范围为 0 至 6.9 毫米)。平均角度偏差为 3.81°(范围为 0 至 24.9°)。与无引导植入相比,所有偏差参数在种植体引导植入中均存在显著差异。使用的模板数量对根尖和角度偏差有显著影响,单模板更有利于减小偏差。研究设计和颌骨位置对偏差无显著影响。使用更多固定销可减小偏差(入口处显著)。
计算机引导种植体植入可以是准确的,但必须考虑到显著的偏差。需要进行随机研究来分析各个参数的影响,以便优化该技术。此外,明确的适应证和获益概述将有助于临床医生找到合适的患者。