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与徒手、静态和动态计算机辅助技术相比,机器人手术在牙种植体植入准确性方面的系统评价和荟萃分析。

Dental implant placement accuracy with robotic surgery compared to free-hand, static and dynamic computer assisted techniques: Systematic review and meta-analysis.

作者信息

Sankar Hariram, Shalini M, Rajagopalan Anjana, Gupta Satish, Kumar Amit, Shouket Rukhsar

机构信息

Department of Dentistry, All India Institute of Medical Sciences, Bathinda, India.

Department of Public Health Dentistry, Santosh Dental College and Hospital, Ghaziabad, Uttar Pradesh, India.

出版信息

J Oral Biol Craniofac Res. 2025 Jan-Feb;15(1):69-76. doi: 10.1016/j.jobcr.2024.12.005. Epub 2024 Dec 11.

Abstract

BACKGROUND

This systematic review and meta-analysis compared the accuracy of robotic-assisted dental implant placement (r-CAIS) with conventional freehand, static computer-assisted (s-CAIS), and dynamic computer-assisted (d-CAIS) techniques.

METHODS

A comprehensive search was conducted in PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from January 2000 to January 2024. Studies meeting PICOST criteria, including clinical and in vitro studies, were included. Data on coronal, apical, and angular deviations were extracted for meta-analysis. The risk of bias (RoB) was assessed using the QUIN RoB and JBI RoB tools.

RESULTS

A total of 134 models and 100 patients with edentulous and partially edentulous arches were included. Eight studies (four in vitro, four in vivo) were reviewed, demonstrating that r-CAIS offers superior accuracy compared to freehand, s-CAIS, and d-CAIS techniques. Among the studies, two in vitro and two in vivo studies had a low RoB, while others had a high RoB. The meta-analysis of five studies showed significant improvements in coronal, apical, and angular deviations with robotic systems.

CONCLUSION

Robotic-assisted systems showed greater accuracy than traditional non-robotic systems. However, this finding should be interpreted with caution due to the limited number of clinical studies and potential funding biases. Moreover, the high cost of robotic systems presents challenges for routine clinical implementation. Future research should focus on cost-effectiveness and seek broader clinical validation.

摘要

背景

本系统评价和荟萃分析比较了机器人辅助牙种植体植入术(r-CAIS)与传统徒手、静态计算机辅助(s-CAIS)和动态计算机辅助(d-CAIS)技术的准确性。

方法

于2000年1月至2024年1月在PubMed、谷歌学术、语义学者和考克兰图书馆进行了全面检索。纳入符合PICOST标准的研究,包括临床研究和体外研究。提取关于冠向、根尖向和角度偏差的数据进行荟萃分析。使用QUIN偏倚风险(RoB)和JBI RoB工具评估偏倚风险。

结果

共纳入134个模型以及100例无牙颌和部分无牙颌牙弓患者。回顾了8项研究(4项体外研究,4项体内研究),结果表明与徒手、s-CAIS和d-CAIS技术相比,r-CAIS具有更高的准确性。在这些研究中,2项体外研究和2项体内研究的偏倚风险较低,而其他研究的偏倚风险较高。对5项研究的荟萃分析显示,使用机器人系统时,冠向、根尖向和角度偏差有显著改善。

结论

机器人辅助系统显示出比传统非机器人系统更高的准确性。然而,由于临床研究数量有限以及潜在的资金偏差,这一发现应谨慎解读。此外,机器人系统的高成本给常规临床应用带来了挑战。未来的研究应关注成本效益,并寻求更广泛的临床验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d1a9/11696845/8cdd4cf34e02/ga1.jpg

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