Objectives To comprehensively evaluate and compare the trueness of static, dynamic, and robotic computer-assisted implant surgery (CAIS) against conventional non-guided (NG) protocols across diverse clinical scenarios via an umbrella review. Materials and methods Six electronic databases were searched from inception to May 2026. Eligible systematic reviews (SRs) and meta-analyses (MAs) comparing CAIS modalities (static [sCAIS], dynamic [dCAIS], and robotic [rCAIS]) or CAIS versus NG protocols were included. Methodological quality and evidence certainty were assessed using AMSTAR-2 and GRADE. Primary study overlap was managed through the Corrected Covered Area (CCA) calculation. Results Twenty SRs were included. All CAIS modalities consistently demonstrated superior trueness over NG protocols. Overall, rCAIS exhibited the highest trueness across all parameters; however, publication bias may overestimate its performance. While sCAIS and dCAIS yielded comparable general trueness, dCAIS resulted in significantly lower angular deviations. For specialized indications, network meta-analysis data indicated that rCAIS and dCAIS achieved the lowest spatial deviations for immediate implant placement (IIP). Conversely, sCAIS exhibited the lowest apical deviations for zygomatic implants (ZI). Evidence certainty ranged from high (generalized sCAIS) to low/very low (specialized indications). Conclusion CAIS significantly enhances placement trueness over NG surgery, with rCAIS currently leading in geometric trueness, although publication bias may overestimate its performance. Digital workflow selection must be indication-specific: rCAIS and dCAIS optimize multi-planar trueness for IIP, whereas sCAIS achieves the lowest apical deviations over extended trajectories for ZI cases.

AIM:To evaluate the prevalence and risk indicators of peri-implant diseases in a randomly selected Chinese population. MATERIALS AND METHODS:A total of 819 patients with 1412 implants from eight university hospital databases were clinically and radiographically evaluated along with medical records to assess the prevalence of peri-implant diseases. Potential risk/protective indicators were explored using multilevel mixed-effects logistic regression analysis. RESULTS:According to the 2017 EFP/AAP World Workshop case definitions, the prevalence of peri-implant mucositis at the subject and implant level was 36.4% and 31.3%, respectively. The prevalence of peri-implantitis at the subject and implant level was 4% and 3.3%, respectively. History of periodontitis and heavy smoking were identified as risk indicators for peri-implantitis in the final model. CONCLUSION:In this randomly selected diverse patient sample within China, the prevalence of peri-implant diseases was moderately high (40.4%) after a mean follow-up duration of 6.65 ± 1.18 years post loading.

BackgroundTo investigate the efficacy of psychological intervention using implicit theory combined with virtual reality (VR) in patients with unruptured intracranial aneurysm (UIA) undergoing their first cerebral angiography (CA) after implantation of a flow-diverter stent.MethodsOne hundred and four patients with UIA who underwent their first CA six months after flow-diverter stent implantation in our hospital between October 2022 and October 2024 were enrolled by convenience sampling. The participants were then randomly divided into a control group (n=52) and an experimental group (n=52). The control group received routine nursing intervention, while the experimental group was given both routine nursing and psychological intervention based on implicit theory combined with VR. The levels of anxiety, physiological stress indicators, and treatment compliance were compared between the two groups.ResultsRepeated-measures ANOVA revealed significant group × time interactions for anxiety (SAS: F(2, 204) = 267.89, P < 0.001, ηp² = 0.724), treatment confidence (VAS-TC: F(2, 204) = 101.36, P < 0.001, ηp² = 0.498), and implicit cognition (IAT: F(2, 204) = 598.74, P < 0.001, ηp² = 0.854). Post-intervention (T1) and pre-procedure (T2), the experimental group showed significantly lower SAS scores and higher VAS-TC and IAT scores than the control group (all P < 0.001). Notably, the experimental group’s mean IAT score at T2 (80.1 ± 4.5) exceeded the pre-specified threshold for positive implicit cognition (65 points). During the angiography, the experimental group also demonstrated superior physiological regulation (higher baroreflex sensitivity and heart rate variability indices, all P < 0.001), better examination tolerance (fewer body movements, lower pain scores, P < 0.001), and higher procedural compliance (accuracy of instruction execution: 92.3% vs. 67.5%, P = 0.001) compared to the control group.ConclusionImplicit theory combined with VR can significantly reduce intraprocedural stress responses and increase cooperation during diagnostic and therapeutic procedures, enhancing long-term compliance through the reconstruction of cognitive structures, optimizing autonomic nerve regulation, and improving pain tolerance. The findings provide a multi-dimensional evidence-based reference for the use of psychological intervention in UIA patients following flow-diverter stent implantation.

Zygomatic implant-(ZI) supported prostheses are reliable and effective treatment options for patients with a severely atrophic maxilla or maxillary defects. This article described a novel custom registration plate for dynamic computer-assisted ZI placement in a patient with a narrowed zygoma. By distributing registration points around the zygoma, this registration plate enhanced the accuracy and safety of ZI placement.

PurposeThis study aimed to assess whether zygomatic implant-supported fixed restorations (ZIFRs) provide comparable chewing efficiency and patient-centered outcomes to conventional implant-supported fixed restorations (CIFRs) in edentulous maxilla cases.Material and methodsA total of 29 patients were enrolled in this study. These patients with maxillary edentulism received ZIFR (16) or CIFR (13) treatment between October 2018 and April 2022. Chewing efficiency was evaluated by the subjective assessments of the scales of chewed gums and the variance of the Hue in a two-color chewing gum mixing ability test. In addition, the Oral Health Impact Profile-14 (OHIP-14) was employed to compare the oral health-related quality of life of patients between these two groups.ResultsThere were no significant differences in chewing efficiency between the ZIFR and CIFR groups according to the results of the subjective assessments (P = 0.59 and P = 0.19 in the first and second stroke of the chewing test, respectively) and the variance of the Hue (P = 0.55 in the first stroke and P = 0.28 in the second stroke). Based on OHIP-14 results, the ZIFR group reported less psychological pain, physical disability, and psychological discomfort. In addition, the success rate of implants in the ZIFR and CIFR groups was 100% and 98.1% at the implant level and 100% and 93.75% at the patient level, respectively.ConclusionsWith the limitations of the study, the chewing efficiency of ZIFRs was comparable to CIFRs in the rehabilitation of maxillary edentulism. However, under such conditions, ZIFRs can offer better postoperative quality of life compared to CIFRs.

Dynamic navigation is a technology for computer-assisted dental surgery that utilizes real-time imaging, patient-specific anatomical data, and preoperative planning to dynamically guide surgical instruments in order to optimize clinical outcomes. It improves the precision of dental implant placement, but shifting attention between the surgical site and the monitor causes ergonomic and workflow issues. This model-based proof-of-concept study introduces augmented reality (AR) integration that projects X-Guide navigation data directly onto the surgical field. The AR overlay eliminates repeated head movements, offering a high ergonomics and cognitively efficient paradigm for computer-assisted implant surgery. Results demonstrated precise implant positioning (coronal deviation: 1.6 +/- 1.4 mm; apical deviation: 1.6 +/- 1.2 mm; angular deviation: 2.5 +/- 1.9 degrees) with efficient surgical times (5.9 +/- 2.6 min per implant). Attention shifts caused by looking at the X-Guide monitor were reduced to zero. Results of the author-developed questionnaire showed a high score on the domains of System Usability Scale (SUS; 5.0 out of 5.0) and a low score on the domains of NASA Task Load Index (NASA-TLX; 1.7 out of 5.0), confirming a high acceptability and low workload. Our findings support AR-integrated dynamic navigation as an accurate and ergonomic solution for guided implantology, warranting further clinical validation.

OBJECTIVE:To validate the performance of a novel automated zygomatic implant (ZI) planning tool (Zygoplanner) in an international multicenter cohort. METHODS:Preoperative computed tomography (CT) scans from 69 patients (276 ZIs) who underwent quad zygomatic implant surgery were retrospectively analyzed using Zygoplanner. Automated ZI plans generated by Zygoplanner were compared with the corresponding clinically placed implants. The comparison metrics included three-dimensional bone-to-implant contact (3D-BIC), Zygoma Anatomy-Guided Approach (ZAGA) classification, safety distances to the orbital rim and the inferior border of the zygoma, inter-implant spacing, surgeon subjective assessments, and a blinded Turing test. RESULTS:Compared with clinically-proved manual plans, Zygoplanner-based automated ZI plans achieved significantly higher 3D-BIC values (p < 0.001). In the internal dataset, automated plans showed slightly shorter orbital rim distances (4.51 vs 5.71 mm, p = 0.022) but significantly greater distances to the inferior zygomatic border (8.21 vs 7.20 mm, p = 0.015). In the external dataset, Zygoplanner demonstrated significantly larger inter-implant spacing (3.01 vs 1.18 mm, p < 0.001). Despite these differences, ZAGA classifications remained consistent between both groups. Subjective evaluations by experienced surgeons yielded high scores for stability (4.63/5), feasibility (4.51/5), and safety (4.25/5). In the blinded Turing test, Zygoplanner-generated plans were identified as human expert in 65.2 % of cases, significantly exceeds the 50 % random guessing threshold (p = 0.0075). CONCLUSION:Zygoplanner automatically generates clinically acceptable quad ZI plans with improved 3D-BIC, which effectively reduces the planning complexity and facilitates better preoperative ZI planning. CLINICAL SIGNIFICANCE:Zygoplanner shows strong potential to automate and standardize quad zygomatic implant planning, thereby improving surgical predictability and safety while simplifying the planning workflow. Its automated workflow supports more consistent outcomes and may broaden access to advanced zygomatic implant rehabilitation for patients with edentulous maxillae.

BackgroundZygomatic implant (ZI) is an effective method for restoring masticatory function and mid-facial appearance in patients with severe alveolar ridge resorption, avoiding complex bone augmentation. Dynamic navigation-assisted surgery has been introduced to improve ZI placement accuracy, with registration being a crucial step. However, the current registration method using fiducial screws is limited by their concentrated placement in the mouth, reducing accuracy around the zygomatic bone. This study aims to evaluate the accuracy and clinical outcomes of a novel minimally invasive registration plate in ZI surgery, guiding its clinical application in dynamic navigation-assisted ZI surgery.MethodsThis is a prospective, single-center, parallel-group, non-inferiority randomized controlled trial conducted at Shanghai Ninth People's Hospital, Shanghai, China. We plan to recruit 20 patients who need ZI restoration. The inclusion criteria include severe atrophy of the maxillary alveolar ridge or maxillary bone defects. The anterior region must have adequate bone volume to allow placement of two temporary implants or at least four pins for registration plate fixation, or existing implants or residual teeth can provide stable fixation for the registration plate. Participants will be randomly assigned in a 1:1 allocation ratio into two groups: control group: dynamic navigation registration using traditional titanium screws; experimental group: dynamic navigation registration using the novel registration plate. The group assignment will be blinded for accuracy evaluators. Entry and exit point and angular deviations of the ZI, surgical time, registration accuracy, patient satisfaction, implant survival rate, and adverse event incidence will be assessed.DiscussionA novel minimally invasive registration plate has been designed to extend the coverage of registration points to the zygomatic bone, thereby expanding the registration range for dynamic navigation-assisted zygomatic implant placement. This study aims to compare the new registration approach with the conventional titanium screw-based method to evaluate whether it enhances the accuracy of dynamic navigation-assisted zygomatic implant surgery.Trial registrationName of the registry: Chinese Clinical Trial Registry (ChiCTR). Trial registration number: ChiCTR2500103641 (retrospectively registered). Date of registration: 2025-06-03. First planned enrollment: 2024-11-17. URL of trial registry record: https://www.chictr.org.cn/showproj.html?proj=272887

Objectives This study aimed to develop a deep learning (DL) model for the predictive esthetic evaluation of single-implant treatments in the esthetic zone. Methods A total of 226 samples, each comprising three intraoral photographs and 12 clinical features, were collected for proof of concept. Labels were determined by a prosthodontic specialist using the pink esthetic score (PES). A DL model was developed to predict PES based on input images and clinical data. The performance was assessed and compared with that of two other models. Results The DL model achieved an average mean absolute error (MAE) of 1.3597, average root mean squared error (MSE) of 1.8324, a Pearson correlation of 0.6326, and accuracies of 65.93% and 85.84% for differences between predicted and ground truth values no larger than 1 and 2, respectively. An ablation study demonstrated that incorporating all input features yielded the best performance, with the proposed model outperforming comparison models. Conclusions DL demonstrates potential for providing acceptable preoperative PES predictions for single implant-supported prostheses in the esthetic zone. Ongoing efforts to collect additional samples and clinical features aim to further enhance the model's performance. Clinical significance The DL model supports dentists in predicting esthetic outcomes and making informed treatment decisions before implant placement. It offers a valuable reference for inexperienced and general dentists to identify esthetic risk factors, thereby improving implant treatment outcomes.

PURPOSE:To integrate the medium-term outcomes of four-implant-supported overdentures (IODs) and full-arch fixed restorations (IFRs) in the maxilla. MATERIALS AND METHODS:The search was performed in PubMed, Embase, and Cochrane databases, complemented by manual search. The inclusion criteria were at least 10 maxillary edentulous patients restored by IOD or IFR with at least 5 years of follow-up. Risk of bias (RoB) 2 and Newcastle-Ottawa Scale (NOS) tools were used to assess RoB. The implant survival rate (ISR) was calculated as the primary outcome. Prothesis survival rate, marginal bone loss (MBL), and complications were the secondary outcomes. RESULTS:A total of 16 studies with 5,568 implants met the criteria (9 implants on IODs, 7 implants on IFRs). The weighted ISR of IODs was 94.5% (95% CI [92.1%, 96.9%]; I2 = 84.22%), and subgroup analysis was performed on the attachment system and study type. The weighted ISR of IFRs was 98.5% (95% CI [97.4%, 99.5%]; I2 = 77.88%). For prosthesis survival, the rate of 85.0% in IODs was lower than that of 99.9% in IFRs. MBL after 5 years was -0.27 ± 1.31 mm in IODs and -1.20 ± 0.76 mm in IFRs. Retention loss (0.34 per patient) and dislodgment/fracture of the acrylic teeth (0.09 per patient) were the most common complications in IODs and IFRs, respectively. CONCLUSIONS:Despite the variance of baseline, IFRs had a relatively higher implant and prothesis survival rate than IODs, whereas IODs had less MBL at the 5th year and a higher incidence of complications. Both maxillary IODs and IFRs have predictable medium-term clinical results.

OBJECTIVES:This study aimed to compare the trueness and precision of mandibular molar immediate implant placement (IIP) between dynamic computer-assisted implant surgery (dCAIS) and robotic computer-assisted implant surgery (rCAIS). METHODS:Ten mandibular models with 40 implant sites, consisting of two types of molar extraction sockets (type B: multiple roots with septal bone; type C: single root without septal bone), were divided into the dCAIS group and the rCAIS group for IIP. The pre- and post-operative CBCT were compared, and the trueness of the implants was measured and statistically analyzed. Precision was evaluated using the Levene test (α = 0.05). RESULTS:No significant differences were found between dCAIS and rCAIS in 3D or angular deviations. For trueness, the two groups were comparable (p > 0.05) except that rCAIS performed better in the buccolingual dimension (p = 0.003 at the crest and apex) in type C sockets. For precision, Levene's tests (α = 0.05) showed that dCAIS had significantly better precision across all sockets in the apicocoronal direction (p = 0.009 at the crest, p = 0.022 at the apex) and in the mesiodistal direction at the apex (p = 0.021). CONCLUSIONS:Both dCAIS and rCAIS achieved high trueness and precision for molar IIP. rCAIS achieved higher buccolingual trueness in type C sockets, whereas dCAIS provided greater precision. CLINICAL SIGNIFICANCE:Both dynamic navigation and robotic-assisted systems achieve high accuracy in mandibular molar immediate implant placement. While rCAIS has an advantage in challenging type C sockets, dCAIS requires intentional adjustment in directions with uneven resistance to achieve optimal outcomes.

OBJECTIVES:WNT10A mutations are associated with tooth agenesis. This study aimed to assess the clinical outcomes of dental implants in patients carrying WNT10A mutations with different molecular statuses and phenotypes over a long-term follow-up period. MATERIALS AND METHODS:Patients with tooth agenesis were screened by whole-exome sequencing (WES) from January 2010 to September 2023. Carriers of pathogenic WNT10A mutations who underwent subsequent dental implant therapy were evaluated. RESULTS:WES identified 66 patients with tooth agenesis carrying WNT10A mutations. Of these, 27 patients (11 males/16 females; mean age 19.6 years) met the inclusion criteria. Homozygotes had significantly more missing teeth (24.4 ± 3.8) than heterozygotes (10.9 ± 5.1, p < 0.0001) and compound heterozygotes (13.8 ± 3.5, p = 0.001). A total of 160 conventional implants were placed. Seven implants were lost in four patients before final prosthesis placement, resulting in overall failure rates of 14.8% at the subject level and 4.4% at the implant level. The 5-year cumulative survival rate (range: 0.23-12.74 years) was 85.2% and 95.6% at the subject and implant levels, respectively. The mean marginal bone loss (MBL) was 0.80 mm (95% CI: 0.59-1.02). Subgroup analysis revealed higher MBL in homozygotes (p = 0.002), sites requiring extensive bone augmentation (p = 0.016), anterior regions (p = 0.031), and full-arch bridge cases (p < 0.0001). Patient satisfaction and OHIP-C49 scores were favorable. CONCLUSIONS:Implant rehabilitation is predictable for patients with WNT10A mutations. However, increased MBL observed in homozygotes with severe tooth agenesis and in cases requiring extensive alveolar bone augmentation highlights the importance of genetic diagnosis prior to implant therapy in patients with severe tooth agenesis.

ABSTRACT Objectives To evaluate the feasibility of esthetic assessments based on intraoral scanning data using pink and white esthetic scores (PES/WES). Materials and Methods Thirty samples with both intraoral photographs and scanning data were collected and rated by two observers with excellent consistency independently. PES includes seven variables, and WES includes five. The maximum scores were 14 and 10, respectively. Results The mean PES/WES was 10.60 ± 1.69 and 8.50 ± 1.28 for photographs and 10.97 ± 1.69 and 8.40 ± 1.25 for scanning data. No significant difference was observed between the two sample types. The alveolar process variable had significantly higher scores, while the soft‐tissue color variable had significantly lower scores based on intraoral photographs compared to scanning. Conclusions Intraoral scanning could be a method for the esthetic evaluation of single implant‐supported restorations using PES/WES. The use of three‐dimensional imaging enables the precise assessment of esthetic outcomes, paving the way for improvements in the digital workflow of implant dentistry. However, the limitations of color and texture reproducibility should be noted. Clinical Significance Intraoral scanning data can be used for esthetic evaluation, and reliable results could be achieved with the application of scanning.

PURPOSE:To retrospectively evaluate the clinical outcomes of implant-supported prosthesis in alveolar cleft patients.METHODS:A total of 14 patients with alveolar cleft underwent implant restoration in Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine from January 2015 to January 2023 were collected.Among them,9 were male and 5 were female.The age ranged from 18 to 52 years,with a mean of(26.1±10.6)years.The se-quence treatment history of patients with cleft lip and palate and the effect of implant repair were retrospectively analyzed.RESULTS:Bone grafting in the fissured area failed repeatedly in 1 patient and no implant was implanted.A total of 21 implants were implanted in the remaining 13 patients with alveolar cleft,all of which achieved good osseointegration.In 10 cases,one implant was implanted in each fissure area for single crown or single end bridge repair.In 3 cases,11 implants were implanted in the non-fissure area for fixed bridge repair.Seven patients with single implant were followed up for 6 to 96 months,with an average of(39.4±29.2)months.During their visits,patients underwent various examinations,including pink aesthetic score(PES)averaging 10.16±0.98,white aesthetic score(WES)averaging 8.50±1.23,and probing depth(PD)with a mean of(2.68±0.61)mm.Additionally,gingival index(GI)was recorded with a mean of 1.33±1.10,and marginal bone loss(MBL)was measured with a mean of(0.17±0.35)mm.The width of the mid-labial keratinized mucosa was ob-served to be(5.14±2.10)mm.CONCLUSIONS:Implant-supported prosthesis in the alveolar cleft area after well-estab-lished multidisciplinary sequential treatments have predictable middle-term success rate,satisfactory aesthetic outcomes and stable peri-implant soft and hard tissue conditions.

STATEMENT OF PROBLEM:Although dynamic- and robotic-assisted systems have enhanced control over implant placement, evidence comparing their performance for complete arch implant-supported prosthesis procedures, especially with tilted implants, is lacking. PURPOSE:The purpose of this in vitro study was to compare the implant placement deviations of dynamic computer-assisted implant surgery (dCAIS) and robotic-assisted implant surgery (RAIS) in a complete arch implant-supported prosthesis protocol by focusing on deviations between planned and actual implant positions. MATERIAL AND METHODS:A total of 512 implants were placed in 64 maxillary and 64 mandibular edentulous resin models, with 256 implants per group. Each model received 2 anterior axial and 2 posterior tilted implants. Postoperative cone beam computed tomography (CBCT) scans were superimposed with preoperative plans to measure entry, exit, and angular deviations. Linear mixed-effects models (LMMs) were used for analysis, with the phantom as a random intercept and jaw type, implant angulation, and side as fixed effects (α=.05). RESULTS:Linear mixed model analysis identified a significant effect of surgery type on angular deviation (P<.001). Side significantly affected exit (P=.025) and angular deviation (P=.002). Significant interactions were observed between surgery type and implant axial type for entry deviation (P=.011) and between surgery type and side for angular deviation (P=.027). Post hoc analysis revealed a significant difference in entry deviation between axial and tilted implants within the dCAIS group (P=.003) and a side-related difference in angular deviation within the RAIS group (P=.005). CONCLUSIONS:RAIS showed reduced deviations, especially for tilted implants, suggesting its potential to enhance control in complete arch implant-supported prostheses.

This study aimed to compare the accuracy of immediate implant placement (IIP) with different implant macrogeometry using a dynamic navigation in the maxillary aesthetic zone. Seventy-six extraction sockets in the maxillary aesthetic zone from nineteen partially edentulous models were randomly divided into four implant system groups with different macrogeometry: non-progressive and trapezoidal (NP-T), progressive and trapezoidal (P-T), progressive and V-shaped (P-V), progressive and spiral (P-S). The coronal, apical, and angular deviations of the fully guided implants with navigation were measured and compared among different groups. Significant differences were detected in coronal, coronal buccolingual, coronal depth, apical, apical buccolingual, and apical depth deviations among the four groups (p = 0.035, p = 0.001, p = 0.004, p = 0.047, p = 0.007, p = 0.004, respectively). The P-V group demonstrated minimal coronal and apical buccolingual deviations (mean ± SD: 0.06 ± 0.35 mm and 0.00 ± 0.42 mm, respectively) for IIP with the guidance of dynamic navigation. With the limitation of the in vitro study, different microgeometry of implants might influence the accuracy of IIP in the maxillary aesthetic zone with dynamic navigation. Implants with progressive and V-shaped thread designs perform best in reducing buccolingual deviations.

To compare the accuracy of marker-based and marker-free registration methods in the context of dynamic navigation guided implant surgery for patients with partial or complete tooth loss. The review includes research articles written in English and Mandarin Chinese published between January 2013 and May 2025, from databases such as MEDLINE/PubMed, Scopus, Cochrane, Embase, China National Knowledge Infrastructure (CNKI) and Web of Science. Both laboratory-based and clinical investigations were taken into account. Thirteen studies, met the specified criteria for inclusion and underwent meta-analysis. Sub-analyses were performed to compare various registration modalities. The assessment of collective evidence was conducted using the GRADE system. No statistically significant differences were observed between registration methodologies i.e; marker based and marker free. Subgroup analysis highlighted a preference for marker-based methods, specifically those utilizing U-shaped markers and bone markers, especially in the lower jaw. No notable variations were noted in terms of time efficiency. Marker-free registration was favored for outcomes reported by patients. Both marker-free and marker-based registration strategies are considered feasible options. Selection should be made based on factors such as practicality, cost, efficiency, clinician preference, and patient-reported outcomes. The results should be interpreted with caution due to the considerable variability among studies, underscoring the necessity for more consistent and dependable data. CRD42024504573.

To determine the most appropriate fiducial markers distribution strategy in navigation surgery for three different tilted implant scenarios by comparing the target registration error (TRE) of tilted implants in fully edentulous maxillae. The cone beam computed tomography scanned a maxillary edentulous model with 16 bone-anchored mini-screws (8 for registration and 8 for target registration error measurement), which was further imported into the navigation system for registration and target registration measurement. Each of the 5 strategies was performed six times, and the measurements were repeated twice around 4 target points each time. A mixed linear model was utilized for data analysis. Registration distribution, measurement site, and their interaction had a statistically significant influence on TREs (P = 0.010, 0.000, and 0.001, respectively). Two markers on the anterior alveolar crest, 2 in the buccal of the anterior alveolar ridge, and 2 on both sides of the maxillary tuberosity can realize the minimal TREs for tuberosity-pterygoid-palatine implant (TPP) at both coronal and apical points. No significant TRE differences were found for apical points of mesial tilted implant in ‘all on four’ and zygomatic implants among the 5 registration strategies. For TPPs, incorporating fiducial markers on maxillary tuberosity for registration can help reduce the TRE in dynamic navigation. Not applicable.

Aim or purpose: To evaluate whether robotic-computer assisted implant surgery (R-CAIS) offers higher placement accuracy than dynamic navigation-computer assisted implant surgery (D-CAIS) in All-on-Four rehabilitation for edentulous jaws, with particular emphasis on the challenges of tilted implant placement inherent to this technique. Materials and methods: This in vitro study involved the placement of 512 implants in 64 maxillary and 64 mandibular edentulous resin models. Each model received two anterior axial implants and two posterior tilted implants, replicating the All-on-Four protocol. Two systems were compared: a dynamic navigation system (Yizhime, DCARER) and a robotic-assisted system (Remebot, Beijing Baihui Weikang Technology Co., Ltd.). Postoperative CBCT images were registered to preoperative plans, and deviations at entry, exit, and angular levels were quantified. Mann–Whitney U tests and linear mixed-effects models (LMM) were used for statistical analysis, with significance set at p < 0.05. Results: R-CAIS demonstrated significantly lower median entry deviation (0.66 mm vs. 0.80 mm, p < 0.01) and angular deviation (0.87° vs. 1.97°, p < 0.01) compared to D-CAIS. No significant difference was found in exit deviation (p = 0.35). Tilted implants showed significantly greater entry deviation than axial implants (p = 0.002), particularly in the D-CAIS group. Conclusions: Robotic-assisted surgery provides superior reliability and accuracy in All-on-Four implant placement, particularly in the context of tilted implant positioning, demonstrating its potential advantage in complex full-arch rehabilitations.

ObjectivesThe purpose of this scoping review was to evaluate the performance of artificial intelligence (AI) in the prognosis of dental implants.DataStudies that analyzed the performance of AI models in the prediction of implant prognosis based on medical records or radiographic images. Quality assessment was conducted using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Quasi-Experimental Studies.SourcesThis scoping review included studies published in English up to October 2023 in MEDLINE/PubMed, Embase, Cochrane Library, and Scopus. A manual search was also performed.Study selectionOf 892 studies, full-text analysis was conducted in 36 studies. Twelve studies met the inclusion criteria. Eight used deep learning models, 3 applied traditional machine learning algorithms, and 1 study combined both types. The performance was quantified using accuracy, sensitivity, specificity, precision, F1 score, and receiver operating characteristic area under curves (ROC AUC). The prognostic accuracy was analyzed and ranged from 70% to 96.13%.ConclusionsAI is a promising tool in evaluating implant prognosis, but further enhancements are required. Additional radiographic and clinical data are needed to improve AI performance in implant prognosis.Clinical significanceAI can predict the prognosis of dental implants based on radiographic images or medical records. As a result, clinicians can receive predicted implant prognosis with the assistance of AI before implant placement and make informed decisions.