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.

The aim of this study is to assess the stress distribution on the bone tissue and bone-implant interface of a customized anatomic root-analog dental implant (RAI) by means of finite element analysis (FEA) for different types of bone density. A mandibular right second premolar was selected from the CBCT database. A DICOM file was converted to an STL file to create a CAD model in FEA software. The bone boundary model was created, while bone density types I–IV were determined. Von Mises stress was measured at bone tissues and bone-implant interfaces. To validate the models, the RAI was 3D printed through a laser powder-bed fusion (L-PBF) approach. The results revealed that all RAI designs could not cause plastic deformation or fracture resulting in lower stress than the ultimate tensile stress of natural bone and implant. Compared to a conventional screw-type implant, RAIs possess a more favorable stress distribution pattern around the bone tissue and the bone-implant interface. The presence of a porous structure was found to reduce the stress at cancellous bone in type IV bone density.

Computer-assisted implant surgery (CAIS) is increasingly performed to reduce deviations in implant position. Dynamic CAIS or navigation systems provide instant display of implant drilling instruments and patient positions directly on the computer monitor. Augmented reality (AR) technology allows operators to visualize real-time information projected onto the lenses of AR glasses. Although AR is being used in medical applications, there are few clinical studies on applying AR glasses to dental implants. The purpose of this randomized clinical study was to compare the accuracy of implant position using the dynamic CAIS with and without AR glasses. Twenty patients who needed a single dental implant were randomly divided into two groups: combined dynamic CAIS with AR glasses (AR glasses group, n = 10) and dynamic CAIS without AR glasses (non-AR glasses group, n = 10). Three-dimensional (3D) deviations of implant platform, apex and angular deviations were measured and analyzed using independent t-tests (P < 0.05). The 3D angular deviations in the AR glasses and non-AR glasses groups were 1.47 ± 1.01° and 2.42 ± 0.76°, respectively. Mean 3D entry point and apical deviations were 0.75 ± 0.45 mm and 0.87 ± 0.45 mm in the AR glasses group, whereas the non-AR glasses group were 1.11 ± 0.44 mm and 1.18 ± 0.50 mm, respectively. There was no statistically significant difference between the two groups. Implant position accuracy using dynamic CAIS with AR glasses was similar to dynamic CAIS without AR glasses during a single implant placement.