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Published on: October 18, 2021
Does robotic surgery offer the highest accuracy for delayed implant placement in single-tooth spaces? A network
Basel Mahardawi1, Sirimanas Jiaranuchart1, Golnaz Tajmiri1
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand; Oral and Maxillofacial Surgery and Digital Implant Surgery Research Unit, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Objective:
The aim of this network meta-analysis was to collectively synthesize the evidence on computer-assisted implant surgery (CAIS), with its static, dynamic, and robotic types, for delayed implant placement in single-tooth spaces, in order to explore whether robotic surgery provides comparable accuracy to other implant placement techniques, based on homogenous data from studies with the same design and population.
Methods:
Literature search was performed in Scopus, MEDLINE/PubMed, and Cochrane library, screening for randomized clinical trials, in which delayed implant placement was performed in single-tooth spaces, reporting information on at least one aspect of platform, apex, and angle deviation. A frequentist network meta-analysis was performed.
Results:
Eleven studies were included. All CAIS methods demonstrated significantly less deviation compared with freehand implant placement. Robotic CAIS ranked the highest among all techniques and showed significantly less apex deviation than static CAIS (MD= -0.42, 95% CI -0.71; -0.13), as well as lower angle deviation compared with both static and dynamic surgery (MD= -1.65, 95% CI -2.89; -0.40, and MD= -1.26, 95% CI -2.39; -0.13, respectively). The certainty of evidence in the outcomes of the meta-analysis ranged from very low to moderate.
Conclusions:
Robotic surgery provides high accuracy for delayed implant placement in single-tooth edentulous sites, superior to other CAIS methods. Nevertheless, the low number of studies available and limited evidence necessitate further exploration of its overall performance, in order to validate these conclusions.
Clinical Significance:
This study offers strong insight into the performance of robotic CAIS, and how it compares with the other well-established treatment modalities, thus demonstrating the potential of this technology to reach superior accuracy, which can be utilized in cases demanding high precision, such as immediacy with prefabricated components, or flapless surgery.