ACCURACY OF STATIC, DYNAMIC, AND ROBOTIC COMPUTER-ASSISTED IMPLANT SURGERY: A PRISMA 2020-BASED SYSTEMATIC REVIEW

ntroduction: Computer-assisted implant surgery (CAIS) improves the transfer accuracy of virtual plans to clinical placement. Static guides, dynamic navigation, and robotic protocols aim to reduce positional deviations and enhance surgical predictability. This systematic review evaluated the clinical accuracy of static, dynamic, and robotic CAIS based on planned-versus-actual implant deviations.

Methods: This PRISMA 2020-based review searched PubMed and Scopus on 26 May 2026 for English clinical studies (2016–2026) reporting quantitative implant placement accuracy. Reviews, case reports, in vitro, cadaveric, phantom, simulation, technical, and workflow-only studies were excluded. Primary outcomes were angular, coronal, and apical deviations. Methodological quality and risk of bias were assessed using Joanna Briggs Institute (JBI) tools. Findings were synthesized descriptively due to heterogeneity.

Results: From 977 identified records (514 Scopus, 463 PubMed), 598 were screened after duplicate removal. Eligibility assessment of 275 reports yielded 48 included clinical studies. JBI appraisal indicated a generally low-to-moderate risk of bias, supporting outcome reliability. Overall, CAIS demonstrated superior accuracy compared to freehand protocols. Static and dynamic systems showed clinically acceptable, often comparable accuracy. Robotic-assisted surgery showed promising deviation outcomes in recent studies; however, available evidence remained heterogeneous. Accuracy was influenced by guide design, guidance degree, registration workflow, tracking stability, surgical protocol, anatomical conditions, and operator-related factors.

Conclusions: Static, dynamic, and robotic CAIS effectively improve the accuracy of transferring virtual implant plans to clinical placement. However, direct superiority remains difficult to establish due to heterogeneity in study designs, protocols, and outcome reporting. Standardized comparative clinical studies are needed.