Clinical outcomes and accuracy of dental implant placement using computer-aided surgical guides : A systematic review and meta-analysis / Mariam Ahmed Roshdy Ragab ; Supervised Khaled Ahmed Abdeen Zekry , Amr Hosny Elkhadem

Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Prosthodontics

Computer-aided surgical guides facilitate the placement of dental implants into an ideal position according to a restoratively-driven treatment plan. However, CT-based technologies available today have limitations and questions that require further investigations regarding their effect on guided surgery outcomes. The purpose of this study was to systematically review, appraise and sum-up the existing evidence on the clinical outcomes and accuracy of dental implant placement using static computer-aided surgical guides against the conventional freehand (flapped or flapless without templates) technique. This review aimed to include randomized and quasi-randomized controlled trials. Identification of eligible studies was achieved through electronic databases search, visual scanning of key journals, citation searching and reference list searching. Thereafter, data extraction; risk of bias and quality assessment, data synthesis and reporting were carried on. Only three studies met the inclusion criteria. Meta-analysis (quantitative data synthesis) was only feasible for the primary outcome which was implant failure, resulting in no statistical significant difference between the computer-guided group versus the conventional freehand group (flapped or flapless, without templates). For postoperative pain, a narrative synthesis was established, as the heterogeneity (in terms of the used measurement tools and measuring units) that was found between included studies impeded the attempts to a statistical quantitative combination. The accuracy of guided surgery [mean deviation at the entry point (1.4 mm, range: 0.3{u2013}3.7); at the apex (1.6 mm, range: 0.2{u2013}3.7); angular deviation (3.0{u00B0}, range: 0.2{u2013}16{u00B0})) was clearly more than for non-guided surgery 2.8 mm, range: 0.3{u2013}8.3; 3.1 mm, range: 0.3{u2013}7.5 and 9.1{u00B0}, range: 0.6{u2013}27.8{u00B0}

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