METHODS OF STATIC AND DYNAMIC NAVIGATION FOR PROSTHETIC-ORIENTED PLACEMENT OF DENTAL IMPLANTS: COMPARISON OF ACCURACY AND IMPLEMENTATION FEATURES OF THE APPROACHES (LITERATURE REVIEW)

Abstract

Purpose of the study. To analyze available data on the accuracy of dental implant placement using static and dynamic navigation systems and compare them with each other, as well as to identify specific indications for the usage of different navigation systems during dental implantation. Research methods. The design of this study was formulated in the form of the retrospective analysis of the literature. The search depth of publications has covered the period from 2017 to 2023. Publications for the analysis have been selected from articles indexed within scientometric databases, and those which text was presented in English and was available for detailed content analysis. Next parameters were used as the categories for an analysis of chosen publications: 1) general indications for the usage of dynamic and static navigation methods in dental implantation; 2) specific indications for the usage of dynamic and static navigation methods in dental implantation; 3) the horizontal deviation levels in the area of an implant platform and at its apical part while implementing the methods of dynamic and static navigations; 4) the angular deviations while implementing the methods of dynamic and static navigations. The following types of publications were analyzed: literature review, systematic review, description of clinical cases (series of clinical cases), results of cohort randomized and non-randomized clinical studies, results of laboratory studies, methodological recommendations. Scientific novelty. The conducted analysis of literature data demonstrated that in the majority of analyzed researches of different evidence levels accuracy levels of dental implants placement using static and dynamic navigation approaches were not critically different. At the same time, however, in separate studies the horizontal and angular deviations were higher while implementing dynamic navigation method compared to static navigation method, which was particularly pronounced in clinical cases of implantation among dental patients with complete edentulism. This outcome can be explained by the higher heterogeneity of the results obtained during accuracy assessment of the dynamic navigation method and registered in available publications. In general, the number of researches focused on the direct comparison of static and dynamic navigation approaches in clinical settings is limited, compared to researches implemented in the laboratory conditions, and researches in which the data of one of the comparators was extracted from previously available systematic data sets rather than determined during the experiment. Conclusions. The usage of static and dynamic navigation methods in the implantological practice helps to achieve a higher correspondence between the implant position achieved as a result of placement and the one planned according to tomographic results and admitting the peculiarities of further prosthetic rehabilitation. Despite the fact that each of the navigation approaches is characterized by specific indications for implementation, the dynamic navigation method demonstrates the following advantages for clinical practice: the ability to implement the approach in one visit; the ability to modify the position of the implant during surgery; higher levels of safety and predictability of the intervention; improved ergonomics of the dentist's work; simplification of a surgical procedure planning process.