The Accuracy of Immediate Implantation Guided by Digital Templates and Potential Influencing Factors: A Systematic Review.

Abstract

Background: Immediate implantation guided by digital templates has drawn a great attention in the aesthetic zone, while the accuracy of immediate implantation guided by digital templates has yielded mixed results and many potential factors are known to affect its accuracy. The purpose of our systematic review was to evaluate the accuracy of implant placement guided by the digital template and summarizing its potentials influencing factors.

Materials and methods: We conducted an electronic search of publications upto July 2023, using PubMed, Embase, the Cochrane Central Register of Controlled Trials, and Web of Science to identify studies on accuracy of immediate implant placement surgery guided by digital templates. We selected cohort studies (prospective and retrospective studies) and randomized controlled trials (RCTs). The primary outcome was accuracy of immediate implant placement surgery guided by digital templates.

Results: Seven studies in total fulfilled the inclusion criteria, comprising two prospective studies and five retrospective studies. We collected data including names of authors, publication period, study design, total sample size, clinical conditionas, planning/preoperative details, surgical procedure information, and evaluation criteria. Average global coronal deviation, apical deviation, depth deviation and angular deviation were respectively 0.74 mm (95% confidence interval [CI] 0.41-1.08, I² = 99.0%), 1.01 mm (95% CI 0.83-1.20, I² = 94.0%), 0.50 mm (95% CI 0.36-0.65, I² = 75.3%) and 2.34° (95% CI 1.68-3.00, I² = 94.5%). The quality assessment was conducted at a medium to high level.

Conclusions and practical implications: Our systematic review demonstrates that immediate implantation guided by digital templates generally achieves acceptable accuracy. Factors influencing accuracy include the type of surgical guide, method of guide fabrication, surgical protocols, anatomical variability, and preoperative planning challenges. To improve clinical application, it is crucial to enhance the reporting of patient-centred outcomes and socioeconomic benefits.