动态导航与静态导航对种植体准确性的Meta分析

Meta-analysis of dynamic navigation versus static navigation in the accuracy of implant surgery

目的系统评价动态导航(dCAIS)与静态导航(sCAIS)对种植体准确性的影响。方法电子检索2000年1月—2022年5月PubMed、Embase、Cochrane Library、Web of Science、CNKI、万方数据库有关dCAIS和sCAIS的对照研究。分别使用NOS和Jadad量表评估队列研究(CS)和随机对照试验(RCT)的偏倚风险,使用RevMan 5.4和Stata 16软件进行Meta分析。结果共12篇研究符合纳入标准,其中CS 8篇,RCT 4篇。按研究对象、缺牙类型、导航系统、配准方式分别进行亚组分析,结果显示,除种植体颈部中心偏差的差异无统计学意义外(P>0.05),dCAIS较sCAIS具备更少的种植体根尖(P<0.05)和角度偏差(P<0.05)。结论基于有限的研究证据,dCAIS较sCAIS具备更佳的种植体准确性,但仍需要更高质量的临床研究来评估两者在相同导航系统和配准方式下在不同缺牙类型中的表现。

Objective To systematically evaluate and compare the accuracy between computer-aided dynamic implant surgery(dCAIS)and computer-aided static navigation(sCAIS)in implant surgery.Methods Databases in PubMed,Embase,Cochrane Library,Web of Science,CNKI and Wanfang from January 2000 to May 2022,were searched to identify controlled trials that compared dCAIS and sCAIS.The risk of bias in cohort studies(CS)and randomized controlled studies(RCTs)was assessed using NOS and Jadad scale,respectively.Data were analyzed using RevMan 5.4 and Stata 16 software.Results A total of 12 studies fulfilled the inclusion criteria,including 8 CS and 4 RCTs.Subgroup analysis,which was conducted according to object,edentulous category,navigation system,registration method,indicated that dCAIS resulted in significantly less implant apical deviation(P<0.05)and angular deviation(P<0.05)than sCAIS,except for implant platform deviation(P>0.05).Conclusion Limited evidence implied that dCAIS could achieve higher accuracy in implant surgery than sCAIS.Further evidence from higher-quality clinical studies are needed to supervise the current performance in diverse edentulous category under the coherent navigation system and registration.