Acurácia da instalação de implantes em cirurgia estática e por navegação dinâmica em edêntulos parciais: revisão sistemática

Autores

1 – Denis Henrique Dias Reghini
Mestre em Odontologia Digital – São Leopoldo Mandic. 0009-0000-1105-9292.

2 – Jenival Correia de Almeida Jr.
Doutor em Implantodontia e especialista em Prótese Dentária – São Leopoldo Mandic. 0000-0003-4828-5319.

3– Eduardo Mukai
Doutor em Ciências da Odontologia – Fousp. 0000-0002-0408-5799.

4 – Newton Sesma
Doutor em Prótese Dentária – Fousp. 0000-0001-5044-1742.

DOI: https://doi.org/10.71440/2675-5610.10.2.25.178-185.art

Resumo

Objetivo: avaliar a acurácia das cirurgias estáticas e dinâmicas assistidas por computador em edêntulos parciais. Material e métodos: esta revisão sistemática seguiu as diretrizes PRISMA. A busca foi realizada nas bases de dados PubMed/MEDLINE, Cochrane Oral Health Group Trials Register e Science Direct, abrangendo artigos em inglês publicados entre 1981 e 2023. A estratégia de busca incluiu termos relacionados a mandíbulas edêntulas parciais e cirurgias assistidas por computador. Foram incluídos ensaios clínicos randomizados, estudos de intervenção não randomizados e estudos in vitro. A avaliação de risco de viés utilizou as ferramentas RoB 2, ROBINS-I e CRIS checklist adaptada. Resultados: foram identificados 524 estudos, sendo 15 incluídos na análise final. Dentre esses, quatro estudos possuíam baixo risco de viés (dois ECRs e dois intervencionais). Os outros 11 estudos apresentavam risco moderado de viés em seis deles (um ECR e cinco intervencionais). O risco elevado de viés foi encontrado em cinco estudos (três ECRs e dois in vitro). Nos estudos ECRs com baixo risco de viés, não foram observadas diferenças significativas para os desvios apicais, coronários e angulares entre os dois métodos cirúrgicos. Conclusão: a acurácia das cirurgias estáticas e dinâmicas em edêntulos parciais é moderada, não sendo suportada por estudos bem delineados. A análise revela a necessidade de novos ensaios clínicos randomizados controlados, com amostras maiores e baixo risco de viés, para uma melhor avaliação da eficácia dessas técnicas. Estudos futuros devem focar na padronização dos métodos e na redução das variabilidades para fornecer evidências mais robustas e conclusivas sobre a acurácia dessas abordagens cirúrgicas.

Palavras-chave: Arcada edêntula; Cirurgia assistida por computador; Implantação dentária.

Accuracy of guided static and dinamic implant surgery on partially edentulous patients: systematic review

Abstract

Objective: to evaluate the accuracy of static and dynamic computer-assisted surgeries in partially edentulous patients. Material and methods: this systematic review followed the PRISMA guidelines. The search was conducted in the PubMed/MEDLINE, Cochrane Oral Health Group Trials Register, and Science Direct databases, covering articles published in English between 1981 and 2023. The search strategy included terms related to partially edentulous jaws and computer-assisted surgeries. Randomized clinical trials, non-randomized intervention studies, and in vitro studies were included. The risk of bias assessment used the RoB 2, ROBINS-I, and adapted CRIS checklist tools. Results: a total of 524 studies were identified, of which 15 were included in the final analysis. From these, 4 studies had a low level of bias (2 RCTs, 2 interventional). The other 11 studies presented a moderate risk of bias in 6 of them (1 RCT, 5 interventional). A high risk of bias was found in 5 studies (3 RCTs, 2 in vitro). Regarding the RCTs with a low risk of bias, no statistically significant differences were identified for the apical, coronal, and angular deviations between these two surgical methods. Conclusion: the accuracy of static and dynamic surgeries in partially edentulous patients is moderate and still not supported by well-designed studies. The analysis reveals the need for new randomized controlled trials with larger sample sizes and low risk of bias to better assess the efficacy of these techniques. Future studies should focus on method standardization and to reduce the variability to provide more robust and conclusive evidence on the accuracy of these surgical approaches.

Keywords: Jaw; Edentulous; Surgery; Computer-assisted; Dental implantation.

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