Schiavon Lucia, Mancini Leonardo, Settecase Eugenia, Jung Ronald E, Joda Tim
Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Department of Neurosciences, Dentistry Section, University of Padova, Padua, Italy.
J Periodontal Res. 2025 Jul 10. doi: 10.1111/jre.70010.
This systematic review and network meta-analysis aimed to answer the PICO question: In patients undergoing immediate implant placement (IIP) [P], does Computer-Assisted Implant Surgery (CAIS) [I] lead to higher accuracy [O] compared to free-hand (FH) [C] implant placement?
A systematic search of MEDLINE, Scopus, and Cochrane databases was conducted for randomized clinical trials (RCTs) published between January 2014 and September 2024, comparing accuracy of CAIS and FH for IIP. Two reviewers screened the studies and extracted data for a network meta-analysis.
Of 2064 records screened, 7 RCTs (338 implants and 291 patients) met the inclusion criteria. These RCTs evaluated FH and dynamic, full static, and partial static CAIS for single or partial implant placement. No RCTs analyzing robotic-assisted implant surgery (RAIS) were found. In 71.4% of the studies, IIP was performed in the anterior maxilla using a flapless approach. Accuracy was assessed by angular, cervical, and apical deviations between planned and real implant positions. All CAIS methods demonstrated significantly higher accuracy than FH (p < 0.05), but no significant differences were observed between CAIS approaches.
CAIS significantly improves IIP accuracy, enhancing 3D implant positioning and prosthetic outcomes. All CAIS techniques revealed comparable accuracy, allowing clinicians to select the most suitable approach for each patient.
PROSPERO identification number: CRD42024554241.
本系统评价和网状Meta分析旨在回答以下PICO问题：在接受即刻种植（IIP）的患者中[P]，与徒手（FH）种植体植入[C]相比，计算机辅助种植手术（CAIS）[I]是否能带来更高的准确性[O]？
对MEDLINE、Scopus和Cochrane数据库进行系统检索，查找2014年1月至2024年9月发表的随机临床试验（RCT），比较CAIS和FH在IIP方面的准确性。两名研究者筛选研究并提取数据进行网状Meta分析。
在筛选的2064条记录中，7项RCT（338颗种植体和291例患者）符合纳入标准。这些RCT评估了FH以及动态、全静态和部分静态CAIS用于单颗或部分种植体植入的情况。未发现分析机器人辅助种植手术（RAIS）的RCT。在71.4%的研究中，IIP采用不翻瓣术式在前上颌骨进行。通过计划种植体位置与实际种植体位置之间的角度、颈部和根尖偏差评估准确性。所有CAIS方法均显示出比FH显著更高的准确性（p < 0.05），但CAIS各方法之间未观察到显著差异。
CAIS显著提高了IIP的准确性，改善了三维种植体定位和修复效果。所有CAIS技术显示出相当的准确性，使临床医生能够为每位患者选择最合适的方法。
PROSPERO识别号：CRD42024554241。
