COMPARISONS BETWEEN DIGITAL-GUIDED AND NONDIGITAL PROTOCOL IN IMPLANT PLANNING, PLACEMENT, AND RESTORATIONS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

Abstract

Objectives

The present study aimed to systematically review the current randomized clinical trials (RCTs) with respect to computer-aided design/computer-aided manufactured (CAD/CAM) techniques in the process of implant planning, placement, and rehabilitation.

Materials and Methods

Four independent reviewers conducted an electronic and manual literature search using several databases, including the National Library of Medicine (MEDLINE-PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), and EMBASE. Articles were included if they were RCTs involving the interventions regarding the computer-guided impression, placement, and manufacturing process. The outcomes of interest include clinical and patient-reported outcomes and time efficiency. A meta-analysis was conducted to evaluate the time efficiency, pain severity, accuracy of implant placement, and postsurgery marginal bone level.

Results

A total of 39 and 25 articles were included in the qualitative and quantitative analysis, respectively. The results of the meta-analysis showed that significantly less time was spent performing the digital impression procedure than the conventional impression (P = .002). In addition, the average adjustment time of the final prosthesis was significantly less than the nondigital fabricated prosthesis (P = .0005). Computer-guided groups reported significantly lower painkiller consumption compared to control groups (P = .03).

Conclusions

Digital impressions and CAD/CAM procedures are time-saving and provide stable and predictable outcomes. Moreover, computer-guided surgery can effectuate an accurate implant placement and less postsurgery discomfort.