Guided Dental Implant Surgery: Systematic Review
Abstract
:1. Introduction
2. Materials and Methods
2.1. Protocol and Registration
2.2. Information Sources, Search
2.3. Selection of Studies
2.4. Data Extraction
2.5. Risk of Bias
3. Results
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- ✓
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- Intraoperative (surgery) complications, such as the impossibility of using a drill due to limited opening of the mouth of a patient, buccal bone dehiscence after osteotomy in another patient (both cases in the study by Derksen et al., 2019 [17]), insufficient bone quantity in one patient, and insufficient primary stability in three patients (Vogl et al., 2015 [20]; these cases were not considered in the study statistics, thus resulting in a 100% survival rate).
- ✓
- Postoperative, (prosthetic implant complications) include loss of implants in almost all studies, loosening of the abutment screw in 2 cases in the study by Lopes et al., 2015 [7], in 3 cases in the study by Vogl et al., 2015 [20], in 10 cases in the study by Yamada et al., 2015 [21]; fracture of the definitive prosthesis in 7 cases in the study by Lopes et al., 2015 [22], in 9 cases in the study by Marra et al., 2013 [18], in 2 cases in the study by Vogl et al., 2015 [20]; fracture of provisional prostheses in 2 cases in the study by Meloni et al., 2010 [15], in one case in the study by Yamada et al., 2015 [21]; imperfect fit of the provisional prosthesis in 2 cases in the study by Meloni et al., 2010 [15], in 3 cases in the study by Vogl et al., 2015 [20]; need for occlusal adjustments in 2 cases in the study by Vogl et al. 2015 [20].
- ✓
- Total early failures: 24
- ✓
- Total late failures: 7
- ✓
- Total patients: 226
- ✓
- Patients with early failure: 9
- ✓
- Patients with late failure: 2
- ✓
- Total early failure rate: 1.60%
- ✓
- Total late failure rate: 0.47%
- ✓
- Total early failure rate: 3.98%
- ✓
- Total late failure rate: 0.88%
4. Discussion
- ✓
- does not cause allergies, toxic, or infectious reactions;
- ✓
- offers anchorage for the prosthesis;
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- does not show any signs of fracture or flexion;
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- does not show any mobility when tested through movements obtained with hand tools;
- ✓
- shows no sign of radiolucency on an intraoral radiograph using a parallel beam technique perpendicular to the implant surface.
- Positioning the implants as equidistant as possible and limiting the number of intermediate elements to less than two to avoid micro-movements;
- Adequate splinting of the implants with the provisional restoration;
- Avoid excessive occlusal loading by limiting occlusal contacts in the anterior six teeth and instructing patients to avoid hard foods for up to 8 weeks after the insertion of the provisional restoration.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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First Autor, Data | Type of Study | Number Patient (Female/Male) | Age (Average) | Number Implant | Diameter/Length Implants (mm) | Follow up |
---|---|---|---|---|---|---|
Ciabattoni et al., 2017 [16]; | Prospective | 32 (23/9) | 44–73 (59.5) | 197 in post-extraction sites; 88 in healed sites | / | 3 years |
Derksen et al., 2019 [17] | Prospective | 66 (36/30) | 20–73 (52.4) | 145 | 3.3-4.8/8-10-12 | 1 and 2 years |
Lopes et al., 2015 [7] | Prospective | 23 (13/10) | 34–70 (55.4) | 92 | 4/8-10-11.5-13-15-18 | 1, 3 and 5 years |
Marra et al., 2013 [18] | Prospective | 30 (18/12) | / | 312 | 3.3-3.75-4/8.5-18 | 3 years |
Meloni et al., 2010 [15] | Retrospective | 15 (10/5) | 40–70 (52) | 90 | 4.3-5/10-13 | 18 months |
Polizzi and Cantoni, 2015 [14] | Retrospective | 27 (20/7) | 34–71 (55.8) | 92 in healed sites; 68 in post-extraction sites | / | 5 years |
Pozzi et al., 2012 [19] | Prospective | 27 (12/15) | 38–77 (54.18) | 39 axials; 42 tilted | 2.8-3.2-3.-8/14.4 (axials)-16.1 (tilted) | 43.4 months |
Vogl et al., 2015 [20] | Prospective | 20 (13/7) divided into 2 groups: 9 immediate occlusal loading; 10 non-occlusal load | 33-70 (54) | 21 (with immediate occlusal loading) 31 (without occlusal load) | / | 1 year |
Yamada et al., 2015 [21] | Prospective | 48 (22/26) | 34–74 (56) | 278 | 3.5-4.3-5/8.5-18 | 1 year |
First Autor, Data | State of the Dental Arch | Condition of the Implant Site | Flap/Miniflap/Flapless | Protocol (Immediate Loading, Conventional) | Final Restoration (Months) |
---|---|---|---|---|---|
Ciabattoni et al., 2017 [16]; | Total edentulism | Post-extraction and healed | Flapless | Immediate | / |
Derksen et al., 2019 [17] | Partial edentulism | Healed | Flapless (34) and miniflap (111) | Conventional | 4 |
Lopes et al., 2015 [7] | Total edentulism | Healed | flapless | Immediate | 4 |
Marra et al., 2013 [18] | Total edentulism | Healed | Flapless | Immediate | 4–6 |
Meloni et al., 2010 [15] | Total edentulism | Healed | Flapless | Immediate | 6 |
Polizzi and Cantoni, 2015 [14] | Partial/total edentulism | Post-extraction and healed | Flapless | Immediate | 6 |
Pozzi et al., 2012 [19] | Partial edentulism | Healed | Flapless; miniflap | Immediate | 6 |
Vogl et al., 2015 [20] | Partial edentulism | Healed | Flapless | Immediate | 6–8 |
Yamada et al., 2015 [21] | Total edentulism | Healed | Flapless | Immediate | 4–7 |
First Autor, Data | Failure | Implant Survival Rate | Medium Marginal Bone Loss | Implant-Prosthetic Complications |
---|---|---|---|---|
Ciabattoni et al., 2017 [16]; | Early: 5 in extraction sites (after 6 months) late: 2 in healed sites (after 2 and 3 years) | 97.54% | Mm | Postoperative: implant loss (7). |
Derksen et al., 2019 [17] | 1 early failure (6 weeks) | 99.3% | / | Intraoperative: Inability to use a drill due to limited mouth opening (1), vestibular dehiscence after osteotomy (1). |
Lopes et al., 2015 [7] | Early: 2 after 5 months Late: 1 after 3 years | 96.6% | 1.9 mm | Postoperative: Abutment screw loosening (2), definitive prosthesis fracture (7), implant loss (3). |
Marra et al., 2013 [18] | Early: 3 in the first 3 months, 2 after 6 months Late: 1 after 1 year, 1 after 2 years | 97.9% | Mm | Postoperative: Prosthesis Fracture (9), implant loss (6). |
Meloni et al., 2010 [15] | Early: 2 after 6 months | 97.8% | 1.6 mm | Postoperative: Implant loss (2), imperfect fit of the provisional prosthesis (2), fracture of the provisional prosthesis (1). |
Polizzi and Cantoni, 2015 [14] | Early: 2 after 6 months (post-extraction site) Late: 2 in healed sites (after 2 years) | 97.33% | 1.39 mm | Postoperative: Implant loss (4). |
Pozzi et al., 2012 [19] | Early: 1 axial, 2 tilted, after 4 months in the same patient | 96.3% | 0.6 mm | Postoperative: Implant loss (3). |
Vogl et al., 2015 [20] | 0 | 100% | 0.4 ± 0.5 mm | Intraoperative: Insufficient bone quantity (1), insufficient primary stability (3); Postoperative: Imperfect fit of temporary prostheses (3), occlusal adjustments required (2), fractures (2), abutment screw loosening (3). |
Yamada et al., 2015 [21] | Early: 2 in one patient (2 weeks); 2 in a patient (1 month) | 98.6% | 0.32 mm | Postoperative: Abutment screw loosening (10), temporary fracture prosthesis (1), implant mobility (4). |
First Autor, Data | N. Implant | Early Failure Rate | Late Failure Rate |
---|---|---|---|
Ciabattoni et al., 2017 [16]; | 285 | 1.75% | 0.70% |
Derksen et al., 2019 [17] | 145 | 0.69% | 0% |
Lopes et al., 2015 [7] | 92 | 2.17% | 1.09% |
Marra et al., 2013 [18] | 312 | 1.60% | 0.64% |
Meloni et al., 2010 [15] | 90 | 2.22% | 0% |
Vogl et al., 2015 [20] | 52 | 0% | 0% |
Polizzi and Cantoni, 2015 [14] | 160 | 1.25% | 1.25% |
Pozzi et al., 2012 [19] | 81 | 3.70% | 0% |
Yamada et al., 2015 [21] | 278 | 1.44% | 0% |
Total failure rate | 1.60% | 0.47% |
First Autor, Data | N. Patient | Early Failure Rate | Late Failure Rate |
---|---|---|---|
Derksen et al., 2019 [17] | 66 | 1.51% | 0% |
Lopes et al., 2015 [7] | 23 | 8.69% | 4.35% |
Meloni et al., 2010 [15] | 15 | 13.33% | 0% |
Polizzi and Cantoni, 2015 [14] | 27 | 3.70% | 3.70% |
Pozzi et al., 2012 [19] | 27 | 3.70% | 0% |
Vogl et al., 2015 [20] | 20 | 0% | 0% |
Yamada et al., 2015 [21] | 48 | 4.16% | 0% |
Total failure rate | 3.98% | 0.88% |
First Autor, Data | Type of Study | Exclusion Criteria Adopted in Relation to Cigarette Smoking | Number Patient | Number Implant | Number of Smoking Patients | Number of Failed Implants in Smokers | Biological Complications | |
---|---|---|---|---|---|---|---|---|
Failures Due to Lack of Osseointegration (within 6 Months) | Peri-Implant Pathology, Periimplantitis | |||||||
Ciabattoni et al., 2017 [16]; | Prospective | more than 10 cigarettes/day | 32 | 285 | \ | \ | 5 | \ |
Derksen et al., 2019 [17] | Prospective | smokers were not excluded | 66 | 145 | \ | 1 | 1 | \ |
Lopes et al., 2015 [22] | Prospective | smokers were not excluded | 23 | 92 | 2 (heavy smokers) 1 | \ | 2 | 2 peri-implant pathology |
Marra et al., 2013 [18] | Prospective | smokers were not excluded | 30 | 312 | \ | \ | 3 | 1 implant lost after 2 years (periimplantitis) |
Meloni et al., 2010 [15] | Retrospective | smokers were not excluded | 15 | 90 | 5 (3 patients smoked up to 10 cigarettes a day, 2 smoked more than 10 cigarettes per day) | \ | 2 | 2 periimplantitis |
Polizzi and Cantoni, 2015 [14] | Retrospective | Smoker patients (≤20 cigarettes/day) were not excluded | 27 | 160 | \ | 2 | 2 | 24 implants in 3 patients (periimplantitis) |
Pozzi et al., 2012 [19] | Prospective | more than 10 cigarettes/day | 27 | 81 | \ | \ | 3 | \ |
Vogl et al., 2015 [20] | Prospective | more than 10 cigarettes/day | 20 | 52 | \ | \ | 0 | 3 mucositis |
Yamada et al., 2015 [21] | Prospective | smokers were not excluded | 48 | 278 | 13 | 4 | 4 | \ |
First Autor, Data | Position | Implant Failure | Anterior Position (Number of Implant Failures) | Posterior Position (Number of Implant Failures) | Maxilla (Number of Implant Failures) | Mandibular (Number of Implant Failures) |
---|---|---|---|---|---|---|
Ciabattoni et al., 2017 [16]; | Maxilla\mandible | 7 | \ | \ | 5\193 | 2\90 |
Derksen et al., 2019 [17] | Maxilla\mandible | 1 | \ | \ | 66 | 1\79 |
Lopes et al., 2015 [7] | Maxilla\mandible | 3 | Maxilla (lateral incisor) | 2Maxilla (first molar, second premolar) | 3\72 | 0\20 |
Marra et al., 2013 [18] | Maxilla\mandible | 6 | \ | \ | 5\177 | 1\135 |
Meloni et al., 2010 [15] | Maxilla | 2 | \ | \ | 2 | \ |
Polizzi and Cantoni, 2015 [14] | Maxilla | 4 | \ | \ | 4 | \ |
Pozzi et al., 2012 [19] | Maxilla | 3 | 2 ASW | 1 PSW | 3 | \ |
Vogl et al., 2015 [20] | Mandible | \ | \ | \ | \ | \ |
Yamada et al., 2015 [21] | Maxilla | 4 | 2 maxilla (incisive lateral R and incisive lateral L) | 2 maxilla (first molar R and first molar L) | 4 | \ |
Bias Due to Confounding | Bias in Selection of Participants into the Study | Bias in Classification of Interventions | Bias Due to Deviations from Intended Interventions | Bias Due to Missing Data | Bias in Measurement of Outcomes | Bias in Selection of the Reported Result | Overall Bias | |
---|---|---|---|---|---|---|---|---|
Ciabattoni et al., 2017 [16]; | + | + | + | + | + | + | + | + |
Derksen et al., 2019 [17] | + | + | + | + | + | + | + | + |
Lopes et al., 2015 [7] | + | + | + | + | + | + | + | + |
Marra et al., 2013 [18] | + | + | + | + | + | + | + | + |
Meloni et al., 2010 [15] | + | + | + | + | - | + | + | + |
Polizzi and Cantoni, 2015 [14] | + | + | + | + | + | + | + | + |
Pozzi et al., 2012 [19] | + | + | + | + | + | + | + | + |
Vogl et al., 2015 [20] | + | + | + | + | + | + | + | + |
Yamada et al., 2015 [21] | + | + | + | + | + | + | + | + |
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Dioguardi, M.; Spirito, F.; Quarta, C.; Sovereto, D.; Basile, E.; Ballini, A.; Caloro, G.A.; Troiano, G.; Lo Muzio, L.; Mastrangelo, F. Guided Dental Implant Surgery: Systematic Review. J. Clin. Med. 2023, 12, 1490. https://doi.org/10.3390/jcm12041490
Dioguardi M, Spirito F, Quarta C, Sovereto D, Basile E, Ballini A, Caloro GA, Troiano G, Lo Muzio L, Mastrangelo F. Guided Dental Implant Surgery: Systematic Review. Journal of Clinical Medicine. 2023; 12(4):1490. https://doi.org/10.3390/jcm12041490
Chicago/Turabian StyleDioguardi, Mario, Francesca Spirito, Cristian Quarta, Diego Sovereto, Elisabetta Basile, Andrea Ballini, Giorgia Apollonia Caloro, Giuseppe Troiano, Lorenzo Lo Muzio, and Filiberto Mastrangelo. 2023. "Guided Dental Implant Surgery: Systematic Review" Journal of Clinical Medicine 12, no. 4: 1490. https://doi.org/10.3390/jcm12041490
APA StyleDioguardi, M., Spirito, F., Quarta, C., Sovereto, D., Basile, E., Ballini, A., Caloro, G. A., Troiano, G., Lo Muzio, L., & Mastrangelo, F. (2023). Guided Dental Implant Surgery: Systematic Review. Journal of Clinical Medicine, 12(4), 1490. https://doi.org/10.3390/jcm12041490