Abstract
BackgroundNowadays implant placement protocols are widespread among clinicians all over the world. However, available literature, only partially analyses what can be potential benefits for the clinicians and patients, often focusing just on specific aspects, such as accuracy. The purpose of this review is to compare computer guided implant placement with conventional treatment protocols.MethodsA search strategy according to the P-I-C-O format was developed and executed using an electronic MEDLINE plus manual search from 2000 up to December 2016. This review included only randomized controlled trials (RCTs) focusing on subjects treated with digital workflow for oral implant placement compared to conventional procedures. Data were extracted from eligible papers and analysed. All kinds of outcomes were considered, even patient-related and economical outcomes.ResultsThe search strategy revealed 16 articles; additional manual searches selected further 21 publications. Afterwards the evaluation of articles, only two studies could be selected for subsequent data extraction. The two identified RCTs analysed primary outcomes as prosthesis failure, implant failure, biological or prosthetic complications, and secondary outcomes as periimplant marginal bone loss. One RCT evaluated also the duration of treatment, post-surgical progress, additional treatment costs and patient satisfaction. The other RCT focused instead on evaluating eventual improvement of patient’s quality of life. In both selected studies, were not observed by the authors statistically significant differences between clinical cases treated with digital protocols and those treated with conventional ones. In one RCT, however post-surgical progress evaluation showed more patients’ self-reported pain and swelling in conventional group.ConclusionsWithin the limitation of this review, based on only two RCTs, the only evidence was that implant survival rate and effectiveness are similar for conventional and digital implant placement procedures. This is also confirmed by many other studies with however minor scientific evidence levels. Reduction of post-operative pain, surgical time and overall costs are discussed. Authors believe that scientific research should focus more in identifying which clinical situations can get greatest benefits from implant guided surgery. This should be done with research protocols such as RCT that assess comprehensively the advantages and disadvantages of fully digital surgical protocols.
Highlights
Nowadays implant placement protocols are widespread among clinicians all over the world
The following questions, that could fulfil the purpose of this work, were formulated: which are clinical advantages and disadvantages of computer guided implant placement compared to conventional treatment protocols? Regarding medical and economic aspect, in which clinical situations guided surgery could be justified?
As regards the accuracy of the digital guided implant surgery, several works have been published in recent years with the aim to scientifically assess the accurateness of these techniques
Summary
Nowadays implant placement protocols are widespread among clinicians all over the world. The purpose of this review is to compare computer guided implant placement with conventional treatment protocols. The use of the first osseointegrated implants to replace missing dental elements, almost 50 years ago, represented a huge evolution in dental rehabilitation techniques [1]. Many solutions have been proposed in order to improve the clinical performance of dental implants [2]. The current trend in implant surgery is to further improve these clinical procedures by reducing total rehabilitation duration using, at the same time, less invasive surgical techniques. Guided implant protocols could help clinicians to simplify their procedures starting from the diagnostic phase up to the realization of the final prosthetic restoration
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