Int J Oral Maxillofac Implants. 2021 Sep-Oct;36(5):e121-e140. doi: 10.11607/jomi.8770.
PURPOSE: Dynamic navigation is a technique that allows for the placement of dental implants using a computer-guided approach according to preoperative planning. Its accuracy has been assessed in several previous studies. The purpose of this study was to summarize data on implant placement accuracy using dynamic navigation, to synthesize the frequency of intraoperative complications and implant failures, and to compare this technique with static computer-guided surgery and a freehand approach. MATERIALS AND METHODS: Electronic and manual literature searches until December 2019 were performed. The outcome variables were implant placement accuracy using dynamic navigation, accuracy differences between dynamic and static techniques and between dynamic and freehand techniques, intraoperative complications, and implant failures. Random-effects meta-analyses were performed. RESULTS: A total of 32 studies were included; 29 reported accuracy values (2,756 implants), and 10 focused on complications and implant failures (1,039 implants). The pooled mean implant placement errors were 0.81 (95% CI: 0.677 to 0.943) mm at the entry point and 0.910 (95% CI: 0.770 to 1.049) mm at the apical point. The pooled mean vertical and angular deviations were 0.899 (95% CI: 0.721 to 1.078) mm and 3.807 (95% CI: 3.083 to 4.530) degrees. The navigation group showed significantly lower implant placement errors with respect to the freehand technique (P < .01) and similar accuracy values (P ≥ .05) compared with the static technique. The pooled prevalence of failures was 1% (95% CI: 0.00% to 2%). CONCLUSION: Dynamic navigation provided small implant placement errors, comparable with those obtained using static computer-guided surgery, and can be considered a more accurate technique than conventional freehand surgery.
目的:动态导航是一种技术,可根据术前规划,通过计算机引导的方法放置牙种植体。以前的几项研究已经评估了其准确性。本研究的目的是总结使用动态导航进行种植体放置准确性的数据,综合术中并发症和种植体失败的频率,并将该技术与静态计算机引导手术和徒手技术进行比较。
材料和方法:进行了电子和手动文献检索,截至 2019 年 12 月。结果变量是使用动态导航进行的种植体放置准确性、动态与静态技术之间以及动态与徒手技术之间的准确性差异、术中并发症和种植体失败。进行了随机效应荟萃分析。
结果:共纳入 32 项研究;29 项报告了准确性值(2756 个种植体),10 项重点关注并发症和种植体失败(1039 个种植体)。汇总的平均种植体放置误差为入口处 0.81(95%置信区间:0.677 至 0.943)mm,根尖处 0.910(95%置信区间:0.770 至 1.049)mm。汇总的平均垂直和角度偏差分别为 0.899(95%置信区间:0.721 至 1.078)mm 和 3.807(95%置信区间:3.083 至 4.530)度。与徒手技术相比,导航组的种植体放置误差明显更低(P <.01),与静态技术相比,准确性值相似(P ≥.05)。失败的汇总患病率为 1%(95%置信区间:0.00%至 2%)。
结论:动态导航可获得较小的种植体放置误差,与使用静态计算机引导手术获得的误差相当,并且可以被认为是比传统徒手手术更准确的技术。
Int J Oral Maxillofac Implants. 2021
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