Xing Qi, Lin Jie, Lyu Mingyue
State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China; Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Department of Oral Implantology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Int Dent J. 2025 Apr;75(2):439-452. doi: 10.1016/j.identj.2024.10.010. Epub 2024 Nov 8.
Immediate implantation guided by digital templates has drawn a great attention in the aesthetic zone, while the accuracy of immediate implantation guided by digital templates has yielded mixed results and many potential factors are known to affect its accuracy. The purpose of our systematic review was to evaluate the accuracy of implant placement guided by the digital template and summarizing its potentials influencing factors.
We conducted an electronic search of publications upto July 2023, using PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science to identify studies on accuracy of immediate implant placement surgery guided by digital templates. We selected cohort studies (prospective and retrospective studies) and randomized controlled trials (RCTs). The primary outcome was accuracy of immediate implant placement surgery guided by digital templates.
Seven studies in total fulfilled the inclusion criteria, comprising two prospective studies and five retrospective studies. We collected data including names of authors, publication period, study design, total sample size, clinical conditionas, planning/preoperative details, surgical procedure information, and evaluation criteria. Average global coronal deviation, apical deviation, depth deviation and angular deviation were respectively 0.74 mm (95% confidence interval [CI] 0.41-1.08, I = 99.0%), 1.01 mm (95% CI 0.83-1.20, I = 94.0%), 0.50 mm (95% CI 0.36-0.65, I = 75.3%) and 2.34° (95% CI 1.68-3.00, I = 94.5%). The quality assessment was conducted at a medium to high level.
Our systematic review demonstrates that immediate implantation guided by digital templates generally achieves acceptable accuracy. Factors influencing accuracy include the type of surgical guide, method of guide fabrication, surgical protocols, anatomical variability, and preoperative planning challenges. To improve clinical application, it is crucial to enhance the reporting of patient-centred outcomes and socioeconomic benefits.
在美学区域，数字模板引导下的即刻种植已引起广泛关注，然而数字模板引导下即刻种植的准确性结果不一，且已知许多潜在因素会影响其准确性。我们进行系统评价的目的是评估数字模板引导下种植体植入的准确性，并总结其潜在影响因素。
我们对截至2023年7月的出版物进行了电子检索，使用PubMed、Embase、Cochrane对照试验中央注册库和Web of Science来识别关于数字模板引导下即刻种植手术准确性的研究。我们选择了队列研究（前瞻性和回顾性研究）和随机对照试验（RCT）。主要结局是数字模板引导下即刻种植手术的准确性。
共有7项研究符合纳入标准，包括2项前瞻性研究和5项回顾性研究。我们收集的数据包括作者姓名、发表时间、研究设计、总样本量、临床情况、规划/术前细节、手术过程信息和评估标准。平均整体冠向偏差、根尖偏差、深度偏差和角度偏差分别为0.74毫米（95%置信区间[CI]0.41 - 1.08，I = 99.0%）、1.01毫米（95%CI 0.83 - 1.20，I = 94.0%）、0.50毫米（95%CI 0.36 - 0.65，I = 75.3%）和2.34°（95%CI 1.68 - 3.00，I = 94.5%）。质量评估为中到高水平。
我们的系统评价表明，数字模板引导下的即刻种植通常能达到可接受的准确性。影响准确性的因素包括手术导板类型、导板制作方法、手术方案、解剖变异和术前规划挑战。为改善临床应用，加强以患者为中心的结局和社会经济效益的报告至关重要。
