Int J Stomatol

Int J Stomatol ›› 2023, Vol. 50 ›› Issue (5): 538-551.doi: 10.7518/gjkq.2023076

• Original Articles • Previous Articles     Next Articles

Meta-analysis of dynamic navigation versus static navigation in the accuracy of implant surgery

Gong Jiaming1(),Zhao Ruimin1,Pan Hongwei2,Lang Xin2,Yu Zhanhai2,Li Jianxue1()   

  1. 1.Dept. of Stomatology, The 940th Hospital of Joint Logistics Support Force of People’s Liberation Army, Lanzhou 730050, China
    2.Dept. of Implantology, School & Hospital of Stomatology, Lanzhou University, Lanzhou 730000, China
  • Received:2022-11-12 Revised:2023-04-04 Online:2023-09-01 Published:2023-09-01
  • Contact: Jianxue Li E-mail:gongjm19@lzu.edu.cn;370816151@qq.com

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Abstract:

Objective To systematically evaluate and compare the accuracy between computer-aided dynamic implant surgery (dCAIS) and computer-aided static navigation (sCAIS) in implant surgery. Methods Databases in PubMed, Embase, Cochrane Library, Web of Science, CNKI and Wanfang from January 2000 to May 2022, were searched to identify controlled trials that compared dCAIS and sCAIS. The risk of bias in cohort studies (CS) and randomized controlled stu-dies (RCTs) was assessed using NOS and Jadad scale, respectively. Data were analyzed using RevMan 5.4 and Stata 16 software. Results A total of 12 studies fulfilled the inclusion criteria, including 8 CS and 4 RCTs. Subgroup analysis, which was conducted according to object, edentulous category, navigation system, registration method, indicated that dCAIS resulted in significantly less implant apical deviation (P<0.05) and angular deviation (P<0.05) than sCAIS, except for implant platform deviation (P>0.05). Conclusion Limited evidence implied that dCAIS could achieve higher accuracy in implant surgery than sCAIS. Further evidence from higher-quality clinical studies are needed to supervise the current performance in diverse edentulous category under the coherent navigation system and registration.

Key words: dynamic navigation, static navigation, dental implant, accuracy, Meta-analysis

CLC Number: 

  • R 783

TrendMD: 

Fig 1

The parameters of implant accuracy"

Fig 2

Flow chart of literature screening"

Tab 1

Characteristics of the included studies"

纳入研究（发表时间）研究设计/对象缺牙类型导航系统配准方式种植体特征种植体数结局指标
Chen等[16]（2018）CS/模型上、下颌牙列缺损AqNavi咬合夹板配准

Titanium

3.5 mm×20 mm

50①②③
-牙支持式50

Mediavilla Guzmán

等[17]（2019）

CS/模型24—26牙位Navident解剖标志点配准

BioHorizons

4.6 mm×12 mm

20①②③
-牙支持式20
Kaewsiri等[18]（2019）RCT/患者单颗牙缺失IRIS解剖标志点配准(3.3~4.8) mm×(8~12) mm50①②③
-牙支持式50
Kivovics等[19]（2022）CS/模型下颌牙列缺失Innoole解剖标志点配准

GmbH

4.2 mm×10 mm

16①②③
-骨固位钉16
Sun等[20] （2020）CS/患者上、下颌牙列缺损AqNaviNRNR32②③
-牙支持式32
Tencati等[21]（2019）CS/患者牙列缺损NRNRNR14①②③
-NR86
Wang等[22]（2022）CS/模型21-22和15-16牙位NRU型管配准4.1 mm×10 mm20①②③
-牙支持式20
Wu等[23]（2020）CS/患者前牙、前磨牙缺失DHCU型管配准NR38①②③
-牙支持式57
Yimarj等[24]（2020）RCT/患者连续2颗或3颗牙缺失IRIS面部框架式配准NR30①②③
-牙支持式30
Zhou等[25]（2020）CS/模型35-36和45-46牙位YizhimeiU型管配准

Straumann

4.1 mm×10 mm

40①②③
-牙支持式40
武玉鹏等[26]（2021）RCT/患者牙列缺损易植美U型管配准NR24①②③
-牙支持式22
赵娅琴等[27]（2021）RCT/患者牙列缺损易植美U型管配准Straumann35①②③
-牙支持式35

Tab 2

Risk of bias in cohort studies"

纳入研究（发表时间）研究人群选择（4分）组间可比性（2分）结果测量（3分）结果/分
暴露组的代表性非暴露组选择方法暴露因素确定方法研究开始前无观察指标研究控制重要因素研究控制其他因素结果评价充分性随访时间充分组间随访完整性
Chen等[16]（2018）√√√√√√6
Mediavilla Guzmán等[17]（2019）√√√√√√6
Kivovics等[19]（2022）√√√√√√6
Sun等[20]（2020）√√√√√5
Tencati等[21]（2019）√√√√√√6
Wang等[22]（2022）√√√√√√√7
Wu等[23]（2020）√√√√√√6
Zhou等[25]（2020）√√√√√√6

Tab 3

Risk of bias in randomized controlled trials"

纳入研究（发表时间）随机序列产生（2分）随机化隐藏（2分）盲法（2分）退出与失访（1分）结果/分
恰当不清楚不恰当恰当不清楚不恰当未使用恰当不清楚不恰当
Kaewsiri等[18]（2019）√√√4
Yimarj等[24]（2020）√√√5
武玉鹏等[26]（2021）√√√4
赵娅琴等[27]（2021）√√√3

Fig 3

Meta-analysis of dCAIS and sCAIS based on subjects"

Fig 4

Meta-analysis of dCAIS and sCAIS based on edentulous category"

Fig 5

Meta-analysis of dCAIS and sCAIS for neck center deviation of implants based on navigation system"

Fig 6

Meta-analysis of dCAIS and sCAIS for root tip center deviation of implants based on navigation system"

Fig 7

Meta-analysis of dCAIS and sCAIS for implant angle deviation based on navigation system"

Fig 8

Meta-analysis of dCAIS and sCAIS for subgroup analysis based on registration method on neck center deviation of implant"

Fig 9

Meta-analysis of dCAIS and sCAIS for subgroup analysis based on registration method on root tip center deviation of implant"

Fig 10

Meta-analysis of dCAIS and sCAIS for subgroup analysis based on registration method on implant angle deviation"

Fig 11

Funnel plots of publication bias ofoutcomes included in the study"

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