Dynamic navigation vs. static navigation in implant placement: A meta-analysis.

OBJECTIVE: The precision of implant surgery is pivotal to the success of implant outcomes. This meta-analysis was conducted to assess the comparative efficacy of static computer-aided implant surgery (sCAIS) and dynamic computer-aided implant surgery (dCAIS) on the accuracy of implant placement. METHODS: A systematic search was performed in the Cochrane Library, PubMed, clinical trial registries, Embase, the Chinese National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases for studies comparing sCAIS and dCAIS up to April 16, 2024. The Newcastle-Ottawa Scale (NOS) was used for the quality assessment of included cohort studies (CSs), and Cochrane Risk of Bias version 2 (RoB2) were utilized to evaluate the risk of bias of included randomized controlled trials (RCTs). The meta-analysis was conducted with RevMan 5.3 software developed by the Cochrane Collaboration. RESULTS: A total of 9 studies, comprising 4 RCTs and 5 CSs, were included in the final analysis. The meta-analysis revealed that dCAIS significantly reduced implant apical deviation (MD=-0.12, 95% CI: -0.23 to -0.02, P = 0.02) and implant depth deviation (MD=-0.20, 95% CI: -0.34 to -0.06, P = 0.004) compared to sCAIS. However, no significant differences were observed in implant platform deviation (MD=-0.01, 95% CI: -0.08 to 0.06, P = 0.74) and implant angular deviation (MD=-0.30, 95% CI: -0.78 to 0.18, P = 0.22) between the two techniques. Egger's test results indicated no evidence of publication bias across the analyzed outcomes (all P > 0.05). CONCLUSIONS: The current evidence suggests that dCAIS offers superior implant accuracy over sCAIS. CLINICAL SIGNIFICANCE: dCAIS may be preferred for use in implant placement. Further high-quality clinical research is necessary to comprehensively evaluate the roles of dCAIS and sCAIS in various types of edentulous conditions, particularly within the context of uniform navigation systems.