Aim: To synthesize evidence on the effect of clinicians' experience on the accuracy of implants placed using Dynamic Computer-Assisted Surgery systems (dCAIS).
Methods: PubMed, Scopus, EMBASE, and Cochrane Library were searched till April 19, 2025, for research reporting implant accuracy with dCAIS along with the influence of the operator's experience. Clinicians who had placed implants with dCAIS (dCAIS-Ex) were compared with those without any prior experience with dCAIS (dCAIS-IEx), irrespective of their experience with implant surgery; clinicians placing implants with dCAIS with or without prior experience in implant surgeries were also compared (IEx vs. I-InEx). The risk of bias was assessed with ROBINS-I for in vivo and QUIN tool for in vitro studies. Meta-analyses were performed to evaluate implant accuracy (coronal, apical, and angular deviations) and operating time.
Results: 4 in vivo and 10 in vitro studies were included. Pooled analysis of in vivo and in vitro studies showed significant differences in angular deviation [SMD = -0.35 (-0.69, -0.01), p = 0.04; SMD = -0.39 (-0.62, -0.17), p = 0.0007], where dCAIS-Ex clinicians showed lower deviations than dCAIS-IEx clinicians. No statistical difference was observed in implant accuracy between I-Ex versus I-IEx clinicians. Data was highly heterogeneous to report conclusive evidence on operating time with dCAIS between respective groups.
Conclusions: The influence of clinicians' experience was significant only on angular deviation when implants were placed by dCAIS-Ex vs. dCAIS-InEx clinicians. However, the small magnitude of difference might not be clinically perceptible. More randomized clinical trials with high quality and standardized methodology are required to synthesize meaningful evidence.
Keywords: dental implant; guided surgery; implant accuracy; navigation; optimal implant positioning.
© 2025 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.