Intraoral scan versus cone beam computed tomography to assess implant position: A systematic review and meta-analysis

The use of intraoral scanners (IOSs) has been proposed as a method of assessing implant position and measuring its deviation from preoperative planning. However, as the current studies offer only preliminary results, a collective quantitative synthesis of the existing data is needed to confirm their reliability.

The purpose of this study was to synthesize data from the available literature and evaluate the possibility of IOSs as an alternative to cone beam computed tomography (CBCT) for assessing implant position.

A search process was done in the Scopus, MEDLINE/PubMed, Dentistry and Oral Sciences Source (part of EBSCO), and Cochrane Library databases to screen for studies that compared IOSs with CBCT, either as a reference or by reporting data on implant deviation from both methods. Studies presenting information on platform, apex, and angle deviation were included.

Fourteen studies fulfilled the inclusion criteria. When compared with reference CBCT, IOSs showed a deviation of 0.27 mm (95% CI 0.13 to 0.42, 95% PI 0.06 to 0.49), 0.22 mm (95% CI 0.14 to 0.30, 95% PI 0.07 to 0.37), and 1.24 degrees (95% CI 0.48 to 1.99, 95% PI -0.4 to 2.86) in platform, apex, and angle, respectively. A meta-analysis of studies comparing implant deviation measured by both CBCT and IOS showed no significant difference between the 2 methods in platform (MD=0.06, 95% CI -0.01 to 0.14, 95% PI -0.13 to 0.22, P=.103), apex (MD=0.05, 95% CI -0.03 to 0.13, 95% PI -0.18 to 0.26, P=.202), and angle (MD=0.19, 95% CI -0.10 to 0.48, 95% PI -0.28 to 0.55, P=.202). Based on the GRADE system, the level of evidence in the clinical studies analyzed (2 studies) was judged as being of "very low certainty" for all outcomes.

IOSs could be a feasible and less invasive alternative to CBCT for assessing the trueness of implant position to the planned one. The results of this meta-analysis should be further confirmed considering the low number of clinical studies available.