Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
Second Dental Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China; Shanghai Research Institute of Stomatology, Shanghai, China; Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
J Dent. 2023 Aug;135:104567. doi: 10.1016/j.jdent.2023.104567. Epub 2023 May 30.
OBJECTIVES: To evaluate the accuracy of dynamic computer-aided implant surgery (dCAIS) and compare it with static computer-aided implant surgery (sCAIS) and freehand implant placement (FH) in partially or fully edentulous patients. DATA: Studies that analyzed the accuracy of dynamic computer-assisted implant surgery in partially or fully edentulous patients. SOURCES: This meta-analysis included studies published in English and Mandarin Chinese from January 2013 to February 2023 from MEDLINE/PubMed, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and CNKI (China National Knowledge Infrastructure). STUDY SELECTION: Only clinical studies were included. Accuracy was the primary outcome. Seventeen studies met the inclusion criteria. A total of 2,025 implants were analyzed. Meta-regression was conducted to compare the six different navigation systems. GRADE (Grading of Recommendations Assessment, Development, and Evaluation) assessment was adopted as a collective grading of the evidence. CONCLUSIONS: Dynamic navigation is a clinically reliable method for implant placement. Significantly lower angular deviation was observed for dCAIS compared to both sCAIS and FH, while significantly lower global platform and apex deviations were displayed between dCAIS and FH. Overall, dynamic navigation allowed for higher accuracy compared to both sCAIS and FH in a clinical setting; however, additional large sample RCT studies should be conducted, and patient-reported outcome measures (PROMs) reported. CLINICAL SIGNIFICANCE: This systematic review analyzed the accuracy of dynamic computer-assisted implant surgery in partially or fully edentulous patients compared with static navigation. The results demonstrated that dynamic navigation could decrease implant placement angular deviations.
目的：评估动态计算机辅助种植手术（dCAIS）的准确性，并与静态计算机辅助种植手术（sCAIS）和徒手种植（FH）在部分或全口缺牙患者中的准确性进行比较。
数据：分析动态计算机辅助种植手术在部分或全口缺牙患者中准确性的研究。
来源：本荟萃分析纳入了 2013 年 1 月至 2023 年 2 月期间发表在 MEDLINE/PubMed、Embase、CENTRAL（Cochrane 对照试验中心注册库）和中国知网（CNKI）的英文和简体中文研究。
研究选择：仅纳入了临床研究。准确性是主要结局。符合纳入标准的研究共 17 项，共分析了 2025 个种植体。采用元回归比较了六种不同的导航系统。采用 GRADE（推荐评估、制定与评价）评估作为证据的综合分级。
结论：动态导航是一种临床可靠的种植体植入方法。与 sCAIS 和 FH 相比，dCAIS 的角度偏差明显更小，而与 FH 相比，dCAIS 的平台和根尖偏差明显更小。总体而言，动态导航在临床环境中比 sCAIS 和 FH 具有更高的准确性，但应开展更多的大型随机对照试验研究，并报告患者报告的结果测量（PROMs）。
临床意义：本系统评价分析了动态计算机辅助种植手术在部分或全口缺牙患者中与静态导航相比的准确性。结果表明，动态导航可以减少种植体植入的角度偏差。
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