Comparison of CAD/CAM and conventional surgical splints in accuracy of orthognathic surgical planning - a systematic review and meta-analysis

ObjectiveThe objective of this systematic review was to evaluate the accuracy between CAD/CAM and conventional splints.Search methods/Selection criteriaOnline databases (PubMed, Dental and Oral Science, CINAHL, Cochrane Central Register of Controlled Trials) were systematically searched. Randomized and non-randomized control trials on human subjects were considered regardless of language or year of publication. Orthognathic patients in which both CAD/CAM and conventional splints present were included. The outcome assessed was accuracy of splints. The risk of bias in clinical trials was assessed using the Cochrane Collaboration tool. The meta-analysis was conducted using the RevMan software V.5.4. The outcome was estimated using weighted average difference and 95% confidence intervals (CIs). The studies' heterogeneity was assessed using Cochrane's heterogeneity test (I2 Test).ResultsA total of six articles fulfilling the inclusion criteria w.ere included, out of which four were included in quantitative synthesis. Accuracy of splints was analysed in a total number of 203 patients. It was found that the CAD/CAM splints were more accurate in comparison to conventional splints. However, this difference was not statistically significant.ConclusionsIn this systematic review and meta-analysis, we assessed the accuracy of CAD/CAM splints in comparison with conventional splints among orthognathic patients and we found no significant difference with any point in three planes Frankfort horizontal, coronal and sagittal in the meta-analysis, but the position of the diamond in the forest plot is closer to the CAD/CAM side, thus, favouring the prototype 3D-printed (CAD/CAM) splints, even though non-significant.REGISTRATIONPROSPERO (CRD42023461941)