Static computer-aided implant surgery (s-CAIS) analysing patient-reported outcome measures (PROMs), economics and surgical complications: A systematic review

Objective: To systematically evaluate the scientific literature for patient-reported outcome measures (PROMs) in static computer-aided implant surgery (s-CAIS). Methods: A PICO strategy was executed using an electronic (MEDLINE, EMBASE, CENTRAL), plus manual search up to 15-06-2017 focusing on clinical studies investigating s-CAIS with regard to patients' pain & discomfort, economics and/or intra-operative complications. Search strategy was assembled from multiple conjunctions of MeSH Terms and unspecific free-text words. Assessment of risk of bias in selected studies was made at a " trial level" applying the Cochrane Collaboration Tool and the Newcastle-Ottawa Assessment Scale, respectively. Results: The systematic search identified 112 titles. Seventy abstracts were screened, and 14 full texts were included for analysis. A total of 484 patients were treated with s-CAIS for placement of 2,510 implants. Due to the heterogeneity of the included studies, meta-analyses could not be performed. Conclusions: The number of identified studies investigating s-CAIS for PROMs was low. Scientifically proven recommendations for clinical routine cannot be given at this time; however, the number of clinical complications with s-CAIS seems to be negligible and comparable to conventional implant surgery. s-CAIS may offer a beneficial treatment option in edentulous cases if a flapless approach is applicable. Nevertheless, the economic effects in terms of time efficiency and treatment costs are unclear. Clinical investigations with well-designed RCTs investigating PROMs with standardized parameters are compellingly necessary for the field of s-CAIS.