Navigation implant surgery accuracy in different types of edentulism: A systematic review and meta-analysis

Objectives: To assess the accuracy of dynamic computer-assisted implant surgery (d-CAIS) in dental implant placement for single, partial, and complete edentulism, and to compare how these edentulism types affect surgical accuracy. Data: Any published studies, except for case reports, assessing d-CAIS accuracy were included until April 15, 2025. Risk of bias was assessed. Random-effects meta-analyses assessed linear and angular deviations at platform and apex levels, and examined differences among single, partial, and complete edentulism groups (p < 0.05). Sources: Electronic search was performed on MEDLINE, PubMed, Embase, Cochrane Library, along with hand-searching and cross-referencing without any limitation for publication year. Study selection: Data from 24 clinical studies, including 687 patients and 1147 dental implants, were analyzed to assess d-CAIS accuracy. The meta-analysis at the implant level found a mean overall accuracy of 1.03 mm CI [0.95; 1.11] at the platform, 1.18 mm CI [1.10; 1.27] at the apex, and 2.90 °CI [2.61; 3.17] for angular deviation. For single tooth gaps, deviations were 0.90 mm CI [0.82; 0.98] at the platform, 1.02 mm [0.88; 1.16] at the apex, and 2.65° [2.19; 3.11]. Partial edentulism groups showed 1.08 mm [0.96; 1.20] at the platform, 1.23 mm [1.14; 1.32] at the apex, and 3.10° [2.75; 3.45] for angular deviation. Complete arches had 1.15 mm [0.85; 1.56] at the platform, 1.41 mm [1.14; 1.67] at the apex, and 2.59° [1.51; 3.68] for angular deviation. Single tooth gaps demonstrated greater accuracy compared to partial and complete edentulism at the platform (p = 0.0212) and apex (p = 0.0101). No significant differences were observed in angular deviation (p = 0.2611). Conclusions: Within the limitations of this study, d-CAIS demonstrated reliable and comparable accuracy for dental implant placement across all types of edentulism. Greater linear precision at both platform and apex was measured in single-tooth implant placement compared to partial or complete edentulous cases, although these differences were not clinically significant. No significant differences in angular deviations between groups were observed. Clinical significance: Even if single-tooth gap resulted the most accurate when compared to partial edentulism and complete arches, these differences were not clinically significant. dCAIS may be used for dental implant placement in various types of edentulism.