动态导航技术对口腔种植精准度影响的Meta分析

Accuracy of dynamic navigation in dental implant surgery:a Meta-analysis

目的 评估动态导航技术辅助口腔种植体植入的精准度以及相关影响因素。方法 计算机检索PubMed、Web of Science、Cochrane Library数据库和中国知网(CNKI),检索日期截至2022-01-31。并手工检索纳入研究的参考文献作为补充,对动态导航在种植手术中种植体植入的精准度进行Meta分析。研究的主要结局指标为动态导航辅助下种植体植入位置与计划中位置的偏差。结果 14篇文献符合纳入标准,共纳入666颗在动态导航下行种植手术的种植体。Meta分析结果显示,种植体平均颈部偏差为1.01 mm(95%CI:0.84~1.17,I~2=98.2%),平均根尖偏差为1.25 mm(95%CI:0.92~1.58,I~2=99.3%),平均角度偏差为3.08°(95%CI:2.23~3.94,I~2=99.5%)。Meta回归分析结果显示,导航下种植区域在上颌骨和下颌骨之间的精准度(颈部、根尖、角度偏差)差异无统计学意义(P值分别为0.830、0.711、0.301);在研究设计为模型研究和临床研究的种植精准度(颈部、根尖、角度偏差)差异无统计学意义(P值分别为0.212、0.133、0.128)。结论 动态导航下进行种植手术是一种相对安全且高效的手术操作方法,但需要更多的高质量研究对精准度差异的影响因素进一步分析证明。

Objective To assess the accuracy of implant placement with dynamic navigation-assisted surgery and its influencing factors. Methods An electronic search was performed to identify studies published before January 31,2022from the databases including PubMed,Web of Science,Cochrane Library and CNKI. Additional manual searches of the related references were also performed. A Meta-analysis was conducted in terms of the accuracy of implant placement under dynamic navigation. The primary outcome index was accuracy of implant insertion with dynamic navigation. Results A total of 14 studies meeting the criteria were included,and 666 implants were evaluated. The Meta-analysis revealed average deviation of implants at the neck was 1.01 mm(95% CI:0.84-1.17,I~2= 98.2%),average deviation of apex was 1.25 mm(95% CI:0.92-1.58,I~2= 99.3%),and average angular deviation was 3.08°(95% CI:2.23-3.94,I~2= 99.5%).Meta-regression analysis showed no difference between the accuracy of maxilla and mandible(P = 0.830,0.711,0.301,respectively),or between model studies and clinical trials(P = 0.212,0.133,0.128,respectively). Conclusion The surgery under dynamic navigation is a relatively safe and efficient surgical procedure for implant surgery, but more highquality studies were needed to further analyze and prove the influencing factors of accuracy difference.