Accuracy Of Surgical Template On Maxillary And Mandible With Different Types Of Support In Dental Implant Placement: A Meta Analysis And Systematic Review

Objective:With the improvement of the accuracy on dental implant surgery,more and more implant surgical templates have been put into clinical use.However,there are many factors affecting the accuracy of implant guide.It is of significance to study the factors working in the process of design、manufacture and use of surgical guide to improve the accuracy of surgical guide.This study plans to conduct a meta-analysis of the literature on the accuracy of implant surgery templates with different support methods and the accuracy of implant surgical guide located in maxillary and mandible comparatively.Methods: The literatures were searched in Pub Med、Cochrane Library、Medline、Ebase、Web of Science.After reading the full text,required literature are selected according to the exclusion criteria.The risk of assessment was conducted with the Newcastle-Ottawa Scale(NOS)and Cochrane Collaboration.The effect sizes are angle deviation(°),deviation at the entry point(mm)and deviation at the apex(mm).Stata15.0 was used for meta-analysis.Results: Twelve articles were included in the study,including 6 studies on the accuracy of implant surgery templates when the implant site was located in maxillary and mandible comparatively,and 9 studies on the accuracy of implant surgery templates with different support types.The standardized mean deviation and 95%confidence interval of maxillary and mandibular comparison:angle deviation[SMD=0.22,95%CI(-0.55,0.99)];deviation at the entry point[SMD=-0.14,95%CI(-0.50,0.22)];deviation at the apex [SMD=0.13,95%CI(-0.20,0.46)].There was no marklly differential in maxillary and mandible guided by surgery templates statistically in that 95%CI covers 0.The mean deviation and 95%confidence interval of pairwise comparison are obtained: mucosa V.S tooth [SMD=0.65,95%CI(-1.12,2.42)] at angle,[SMD=0.47,95%(-1.22,2.17)] at entry point and [SMD=0.63,95%CI(-1.02,2.28)] at apex;bone V.S tooth [SMD=1.09,95%CI(-0.78,2.96)] at angle,[SMD=1.13,95%(-0.66,2.92)] at entry point and[SMD=0.98,95%CI(-0.76,2.72)] at apex;bone V.S mucosa[SMD=(0.43,95% CI(-1.24,2.11)] at angle,[SMD=0.66,95%(-0.95,2.27)] at entry point and [SMD=0.36,95%CI(-1.21,1.92)at apex.The above 95% CI were all over 0,and the difference was not significant between different support methods in statistic.Conclusion There is no definite evidence to prove that the position of maxillary and mandible or different support methods of templates have a statistically significant effect on the computer-aided implant surgery.