Abstract
To systematically scrutinize the current scientific literature regarding the clinical advantages of computer guidance of implant placement. Four electronic databases were searched using specified indexing terms. The reference lists of publications were also searched manually. For inclusion, publications had to meet pre-established criteria. The searches yielded 1028 titles and abstracts. After data extraction and interpretation, 28 publications and 2 systematic reviews remained for inclusion. Fifteen studies were prospective observational and four were retrospective observational. Nine studies included a control group (controlled clinical trials) of which seven were prospective and two retrospective. Only three of the prospective studies were randomized (RCT's). A total of 852 patients were treated with 4032 implants using computer-guided implant surgery. The number of patients included in each study ranged from 6 to 206. The age ranged from 16 to 92 years and the follow-up period varied between 1 and 49 months. The limited scientific evidence available suggests that guided placement has at least as good implant survival as conventional protocols. However, several unexpected procedure-linked adverse events during guided implant placement indicate that the clinical demands on the surgeon were no less than those during conventional placement. A clinical advantage with flapless guided surgery is that the technique is likely to decrease pain and discomfort in the immediate postoperative period.
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