Computer-assisted surgery in medical and dental applications

ABSTRACT

Introduction

Computer-assisted surgery (CAS) is a broad surgical methodology that utilizes computer technology to both plan and execute surgical intervention. CAS is widespread in both medicine and dentistry as it allows for minimally invasive and precise surgical procedures. Key innovations in volumetric imaging, virtual surgical planning software, instrument tracking, and robotics have assisted in facilitating the transfer of surgical plans to precise execution of surgical procedures. CAS has long been used in certain medical specialties including neurosurgery, cardiology, orthopedic surgery, otolaryngology, and interventional radiology, and has since expanded to oral and maxillofacial application, particularly for computer-assisted implant surgery.

Areas covered

This review provides an updated overview of the most current research for CAS in medicine and dentistry, with a focus on neurosurgery and dental implant surgery. The MEDLINE electronic database was searched and relevant original and review articles from 2005 to 2020 were included.

Expert opinion

Recent literature suggests that CAS performs favorably in both neurosurgical and dental implant applications. Computer-guided surgical navigation is well entrenched as standard of care in neurosurgery. Whereas static computer-assisted implant surgery has become established in dentistry, dynamic computer-assisted navigation is newly poised to trend upward in dental implant surgery.

KEYWORDS:

• Accuracy
• computer-assisted Surgery
• dental implant
• guided surgery
• meta-analysis
• neurosurgery

Article highlights

• Computer-assisted surgery and surgical navigation systems allow for precise pre-surgical planning and intraoperative guidance, and can be found across virtually every surgical discipline in modern medicine.

• As computer technology evolves, medical demands are expected to capitalize on innovations in robotics and computer-assisted navigation.

• The evolution and evidence-based clinical indications and protocols for static and dynamic computer-assisted navigation in dentistry are described.

• Meta-analyses are presented for surgical implant placement accuracies based on the current literature (2005-2020) for studies of static computer-assisted implant surgery (sCAIS) using tooth-, mucosa, and bone-supported guides and for dynamic computer-assisted dental implant surgeries (dCAIS).

• sCAIS tooth-supported guide protocols are well-established and show the highest accuracy; sCAIS mucosa- and bone-supported guide protocols have evolved in recent years and demonstrate comparable accuracies in recent clinical studies.

• dCAIS protocols have demonstrated significant improvements in the past five years; the clinical accuracy of dCAIS protocols is similar to that for sCAIS protocols in limited recent studies.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.