Marginal Bone Loss Around Dental Implants Inserted with Static Computer Assistance in Healed Sites: A Systematic Review and Meta-analysis

Purpose: The radiologic outcomes of implants placed using static computer-guided surgery have not yet been systematically investigated. The purpose of this study was to evaluate the marginal bone loss (MBL) around dental implants inserted with static computer assistance in healed sites. Materials and Methods: An electronic search of publications in English from three databases (from 2000 to March 2015), including PubMed, Web of Science, and Cochrane Oral Health Group Trials Register, and a hand search of peerreviewed journals for relevant articles were performed. Only clinical human studies, either randomized or nonrandomized, with at least 10 cases and a minimum follow-up time of 12 months, reporting on MBL were included. Results: The search strategy resulted in 18 publications, with 2,675 implants inserted with static computer assistance in healed sites. The pooled mean MBL at 1-year follow-up was 1.06 mm (95% CI: 0.83 to 1.30 mm; heterogeneity: random-effects model, I2 = 99.38%; P .01). Moreover, when considering studies with a 3-year follow-up only (n = 5; 748 implants), the pooled MBL was 1.48 mm (95% CI: 0.81 to 2.15 mm; heterogeneity: random-effects model, I2 = 99%; P .01). Conclusion: Within the limitations of this review, the MBL around dental implants placed in healed sites with computer-guided surgery seems to be a well-functioning one-stage alternative to extended two-stage conventional procedures if patients are appropriately selected and an appropriate width of bone is available for implant placement. However, current evidence is limited by the quality of available studies and the lack of comparative long-term clinical trials. Keywords: bone loss, dental implants, flapless, guided surgery, immediate loading, stereolithography