Computer-assisted implant surgery (CAIS), either static or dynamic, is well documented to significantly improve the accuracy of implant placement. Whether the increased accuracy leads to a corresponding improvement in clinical outcomes has not yet been systematically investigated. The aim of this critical review was to investigate whether the use of CAIS can lead to reduction of complications as well as improved clinical and patient-reported outcomes (PROs) when compared with conventional freehand implant surgery. A comprehensive online search was conducted to identify studies where implants were installed with static computer-assisted implant surgery (s-CAIS)or dynamic computer-assisted implant surgery(d-CAIS) or combinations of the two, either compared with conventional free-hand implant placement or not. Seventy-seven studies were finally included in qualitative analysis, while data from three studies assessing postsurgical pain were suitable for a meta-analysis. Only a small number of the available studies were comparative. The current evidence does not suggest any difference with regard to intraoperative complications, immediate postsurgical healing, osseointegration success, and survival of implants placed with CAIS or freehand protocols. Intraoperative and early healing events as reported by patients in randomized clinical trials (RCTs) did not differ significantly between CAIS used with flap elevation and conventional implant placement. There is limited evidence that increased accuracy of placement with CAIS is correlated with superior esthetic outcomes. Use of CAIS does not significantly reduce the length of surgeries in cases of single implants and partially edentulous patients, although there appears to be a more favorable impact in fully edentulous patients. Although CAIS alone does not seem to improve healing and the clinical and PRO, to the extent that it can increase the utilization of flapless surgery and predictability of immediacy protocols, its use may indirectly lead to substantial improvements in all of the above parameters.

中文翻译：

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计算机辅助种植手术能否改善临床结果并降低种植牙并发症的频率和强度？批判性评论

计算机辅助种植手术 (CAIS)，无论是静态的还是动态的，都可以显着提高种植体植入的准确性。准确性的提高是否会导致临床结果的相应改善尚未得到系统研究。这篇重要评论的目的是调查与传统徒手植入手术相比，使用 CAIS 是否可以减少并发症并改善临床和患者报告的结果 (PRO)。进行了全面的在线搜索，以确定与传统徒手相比，通过静态计算机辅助种植手术 (s-CAIS) 或动态计算机辅助种植手术 (d-CAIS) 或两者结合安装种植体的研究种植体放置与否。77 项研究最终被纳入定性分析，而来自三项评估术后疼痛的研究的数据适合进行荟萃分析。只有少数可用的研究是比较性的。目前的证据表明，在术中并发症、术后即刻愈合、骨整合成功以及使用 CAIS 或徒手操作植入物的存活率方面没有任何差异。随机临床试验 (RCT) 中患者报告的术中和早期愈合事件在使用皮瓣抬高的 CAIS 和传统种植体植入之间没有显着差异。有限的证据表明 CAIS 放置的准确性提高与卓越的美学效果相关。使用 CAIS 不会显着缩短单颗种植体和部分缺牙患者的手术时间，尽管对全口缺牙患者似乎有更有利的影响。虽然单独使用 CAIS 似乎并不能改善愈合和临床和 PRO，但就它可以增加无翻瓣手术的利用率和即时方案的可预测性而言，它的使用可能间接导致上述所有参数的实质性改善。