Safety and Accuracy of Guided Miniscrew Insertion
Author Information
Author(s): Santmartí-Oliver Margalida, Jorba-García Adrià, Moya-Martínez Tania, de-la-Rosa-Gay Cristina, Camps-Font Octavi
Primary Institution: Complutense University of Madrid; University of Barcelona; IDIBELL Institute
Hypothesis
This systematic review and meta-analysis aimed to evaluate the safety and accuracy of miniscrew placement using different guidance approaches.
Conclusion
Guided techniques, particularly static Computer-Assisted Surgery (sCAS), improve the safety and accuracy of miniscrew insertion compared to freehand methods.
Supporting Evidence
- Static Computer-Assisted Surgery (sCAS) significantly reduced root damage compared to freehand methods.
- Eleven studies were included in the review, providing a total of 652 miniscrews.
- The only RCT had 'some concerns' regarding risk of bias.
- Most pre-clinical studies exhibited a high risk of bias.
- Guided techniques showed lower apical, coronal, and angular deviations compared to freehand techniques.
- Radiographic guides did not significantly reduce root damage compared to freehand techniques.
- Future studies should explore dynamic Computer-Assisted Surgery (dCAS) for further accuracy improvements.
- The review highlighted the clinical benefits of sCAS in orthodontics.
Takeaway
Using special guides to place orthodontic screws is safer and more accurate than doing it by hand.
Methodology
A systematic review and meta-analysis of studies on guided miniscrew insertion, assessing safety and accuracy outcomes.
Potential Biases
The only RCT had 'some concerns' regarding risk of bias, and most pre-clinical studies had high bias risk.
Limitations
The review included studies with varying quality and significant heterogeneity in methods, limiting quantitative synthesis.
Participant Demographics
The studies included human, animal, cadaver, and in vitro models.
Statistical Information
P-Value
<0.001
Confidence Interval
95% CI: 0.04–0.36
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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