Schnutenhaus Sigmar, Edelmann Cornelia, Knipper Anne, Luthardt Ralph G
Center for Dentistry, Dr. Schnutenhaus Community Health Center, 78247 Hilzingen, Germany.
Center of Dental, Oral and Maxillofacial Medicine, Clinic for Dental Prosthetics, Ulm University, 89081 Ulm, Germany.
J Clin Med. 2021 Feb 11;10(4):704. doi: 10.3390/jcm10040704.
The aim of this systematic review and meta-analysis is to analyze the accuracy of implant placement using computer-assisted dynamic navigation procedures. An electronic literature search was carried out, supplemented by a manual search. The literature search was completed in June 2020. The results of in vitro and clinical studies were recorded separately from each other. For inclusion in the review, the studies had to examine at least the prosthetically relevant parameters for angle deviation, as well as global deviation or lateral deviation at the platform of the implant. Sixteen of 320 articles were included in the investigation: nine in vitro and seven clinical studies. The meta-analysis showed values of 4.1° for the clinical studies (95% CI, 3.12-5.10) and 3.7° for the in vitro studies (95% CI, 2.31-5.10) in terms of the angle deviation. The global deviation at the implant apex of the implant was 1.00 mm for the clinical studies (95% CI, 0.83-1.16) and 0.91 mm for the in vitro studies (95% CI, 0.60-1.12). These values indicate no significant difference between the clinical and in vitro studies. The results of this systematic review show a clinical accuracy of dynamic computer-assisted navigation that is comparable to that of static navigation. However, the dynamic navigation systems show a great heterogeneity that must be taken into account. Moreover, currently there are few clinical data available. Therefore, further investigations into the practicability of dynamic navigation seem necessary.
本系统评价和荟萃分析的目的是分析使用计算机辅助动态导航程序进行种植体植入的准确性。进行了电子文献检索，并辅以手工检索。文献检索于2020年6月完成。体外研究和临床研究的结果分别记录。纳入本评价的研究必须至少检查与修复相关的角度偏差参数，以及种植体平台处的整体偏差或侧向偏差。320篇文章中有16篇纳入研究：9篇体外研究和7篇临床研究。荟萃分析显示，临床研究的角度偏差值为4.1°（95%CI，3.12 - 5.10），体外研究为3.7°（95%CI，2.31 - 5.10）。临床研究中种植体根尖处的整体偏差为1.00 mm（95%CI，0.83 - 1.16），体外研究为0.91 mm（95%CI，0.60 - 1.12）。这些值表明临床研究和体外研究之间无显著差异。本系统评价的结果显示，动态计算机辅助导航的临床准确性与静态导航相当。然而，动态导航系统显示出很大的异质性，必须予以考虑。此外，目前可用的临床数据很少。因此，似乎有必要进一步研究动态导航的实用性。
