Comparison of the accuracy/precision among guided (static), manual, and dynamic navigation in dental implant surgery:...

To assess whether dynamic navigation (dCAIS) has greater accuracy/precision and less discrepancy in parallelism compared to guided (static, sCAIS) and free-hand (FH) surgery in Implantology.

A search was conducted across six databases using specific key terms. Randomized controlled trials (RCTs), retrospective or prospective clinical studies published within the last 10 years (2014-2024) were included. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal tool. A meta-analysis using a random-effects model was employed. The heterogeneity analysis was conducted using Cochran's Q-test and Higgins' I² statistic.

Thirteen articles were included. A total of 554 patients and 687 implants were enrolled, with 215 using the FH system, 195 using sCAIS, and 277 using dCAIS. The meta-analysis compared the following: (1) dCAIS vs. sCAIS; (2) dCAIS vs. FH; (3) sCAIS vs. FH. The first group had a mean difference of -0.08 mm, with a substantial heterogeneity (I² = 52%) and no statistically significant difference (p = 0.08); the second presented a mean difference of -0.48 mm, high heterogeneity (I²=89%), and a statistically significant better accuracy for dCAIS than FH (p < 0.01); the last comparison found a mean difference of -0.62 mm, with a considerable heterogeneity (I²=84%), and sCAIS showing statistically significantly better accuracy than the FH approach (p < 0.01).

Using CAIS (dCAIS or sCAIS) substantially improved accuracy compared to the FH approach, with no statistically significant difference between dCAIS and sCAIS.

The findings support the use of CAIS for improved implant accuracy and precision compared to FH techniques.