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Systematic review and network meta-analysis of the accuracy of the orthodontic mini-implants placed in the inter-radicular space by image-guided-based techniques. | LitMetric

AI Article Synopsis

  • The systematic review and network meta-analysis (NMA) aimed to compare the accuracy of different techniques for placing orthodontic mini-implants in the inter-radicular space, focusing on image-guided methods versus conventional techniques.
  • Eight randomized experimental trials were included, assessing techniques such as static computer-aided implant surgery, mixed reality, soft tissue static computer-aided implant surgery, and conventional free-hand technique.
  • The results indicated that static computer-aided methods (s-CAIS and ST s-CAIS) had significant advantages over the conventional method, while mixed reality did not show substantial differences; s-CAIS consistently had the best accuracy across various deviation metrics.

Article Abstract

Objective: The aim of the present systematic review and network meta-analysis (NMA) is to analyze the accuracy of image-guided-based orthodontic mini-implants placement techniques in the inter-radicular space.

Methods: The study was conducted under the PRISMA recommendations. Three databases were searched up to July 2022. In vitro randomized experimental trials (RETs) including static computer-aided implant surgery (s-CAIS), mixed reality (MR), soft tissue static computer-aided implant surgery (ST s-CAIS) and conventional free-hand technique (FHT) for the orthodontic mini-implants placement in the inter-radicular space were selected. The risk of bias was assessed using the Current Research Information System scale. A random effects model was used in the NMA. Direct comparisons were combined with a random effects model in a frequentist NMA to estimate indirect comparisons, and the estimated effect size of the comparisons between techniques were analyzed by difference of means. Inconsistency was assessed with the Q test, with a significance level of p < 0.05, and a net heat plot.

Results: A total of 92 articles was identified, and 8 RETs (8 direct comparisons of 4 techniques) were included in the NMA, which examined 4 orthodontic mini-implants placement techniques: s-CAIS, MR, ST s-CAIS, and FHT. Taking FHT as reference, s-CAIS and ST s-CAIS showed statistically significant coronal and apical deviation. In addition, s-CAIS showed statistically significant angular deviation. However, MR did not show statistically significant differences with respect to FHT, which presented the highest p-score. At the coronal deviation, ST s-CAIS presented the highest P-score (0.862), followed by s-CAIS (0.721). At the apical deviation, s-CAIS presented the highest P-score (0.844), followed by ST s-CAIS (0.791). Finally, at the angular deviation s-CAIS presented again the highest P-score (0.851).

Conclusions: Within the limitations of this study, it was found that the image-guided-based orthodontic mini-implants placement techniques showed more accuracy than the free-hand conventional placement technique; specially the computer-aided static navigation techniques for the orthodontic mini-implants placed in the inter-radicular space.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10262426PMC
http://dx.doi.org/10.1186/s12903-023-03079-8DOI Listing

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