Accuracy of static and dynamic computer-aided implant surgery for immediate implant placement: A systematic review and meta-analysis

Abstract

<p><strong>Purpose:</strong> To investigate the accuracy of static and dynamic computer-aided implant surgery (s/d-CAIS) for immediate implant placement for single-tooth replacement in healthy individuals with partially edentulous zones.</p><p><strong>Study selection:</strong> A systematic search of six electronic databases for clinical studies reporting on Type 1 implant placement identified 15 eligible articles (seven RCTs, two prospective studies, and six retrospective studies) involving 383 patients. The focus question addressed population, intervention, comparison, and outcome criteria. A meta-analysis was performed using a random-effects model to obtain pooled estimates, presented as forest plots with weighted mean differences and 95% confidence intervals. Quality assessment was conducted using the Robin-I and RoB2 tools.</p><p><strong>Results:</strong> The meta-analysis revealed that s/d-CAIS demonstrated significantly lower global platform and apex deviation compared to freehand placement, with mean differences of -0.70 mm (95% CI -0.74, -0.66; <em>P</em> < 0.001) and -0.86 mm (95% CI -1.00, -0.73; <em>P</em> < 0.001) respectively. The mean difference in platform depth deviation was statistically significant in favor of CAIS, with a mean difference of -0.73 mm (95% CI -1.04, -0.43; <em>P</em> < 0.001). High heterogeneity was observed across studies. The average global coronal, global apex, and angulation deviation for d-CAIS and s-CAIS were 0.72 mm, 0.81 mm, and 2.04 degrees, and 0.80 mm, 1.10 mm, and 2.12 degrees, respectively.</p><p><strong>Conclusions:</strong> Data on Type 1 implant placement suggest that s/d-CAIS may enhance implant placement accuracy in several dimensions compared with freehand placement, with d-CAIS demonstrating marginally better control over angulation. However, the high heterogeneity across studies with a moderate-to-high risk of bias limits the generalizability of these findings.</p>