Comparison of Precision and Accuracy Between Navigated and Total Guided Surgery in Implantology: A Systematic Review...

Accuracy, precision, and implant parallelism relative to the preoperative plan are critical determinants of implant success and longevity. Ensuring that implants are placed as close as possible to their ideal planned positions optimizes biomechanical stability and esthetic outcomes. The goal was to compare the accuracy and precision of dynamic computer-assisted implant surgery (dCAIS) versus static guided implant surgery (sCAIS), assessing deviations at the platform, apex, and angulation levels.

A comprehensive literature search was conducted across PubMed, B-on, Web of Science, SciELO, Cochrane, ScienceDirect, and gray literature sources, following PRISMA guidelines and the PICO question: "Does navigated surgery present greater accuracy/precision in the placement of dental implants when compared to fully guided surgery?" Eligible studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Tool. Quantitative data were pooled using a random-effects meta-analysis, and sensitivity analyses were performed by excluding studies with small sample sizes (n < 11) or high variability.

Twenty studies met the inclusion criteria, of which eight provided sufficient quantitative data for meta-analysis. Eight studies were included for quantitative analysis; the pooled mean differences between dCAIS and sCAIS initially were not statistically significant for platform deviation (MD = -0.115 mm; p = 0.417), with very high heterogeneity (I² = 91.3%); for apex deviation (MD = -0.102 mm; p = 0.144), with moderate heterogeneity (I² = 52.9%); and for angular deviation (pooled MD = -0.309°; p = 0.430), with substantial heterogeneity (I² = 79.6%). Excluding two studies (outliers), the pooled mean differences between dCAIS and sCAIS were minimal and statistically nonsignificant for platform (MD = 0.02 mm, p = 0.85), apex (MD = -0.08 mm, p = 0.35), and angular deviation (MD = 0.05°, p = 0.87). After the sensitivity analysis, these findings remained stable, confirming the equivalence of both systems in terms of three-dimensional accuracy. Moderate heterogeneity (I² = 65-83%) was primarily attributable to methodological inconsistencies across studies.

Both dynamic and static computer-assisted implant surgeries demonstrate clinically comparable accuracy and precision. Variability among studies underscores the need for standardized reporting of deviation parameters, guide support types, and operator experience. Future research adopting uniform measurement and reporting protocols will enable more reliable cross-study comparisons and refine evidence-based selection between navigation and guided approaches in digital implantology.