Comparison of CAD/CAM and conventional surgical splints in accuracy of orthognathic surgical planning–a systematic review and meta-analysis

Objective: The objective of this systematic review was to evaluate the accuracy between CAD/CAM and conventional splints. Search methods/Selection criteria: Online databases (PubMed, Dental and Oral Science, CINAHL, Cochrane Central Register of Controlled Trials) were systematically searched. Randomized and non-randomized control trials on human subjects were considered regardless of language or year of publication. Orthognathic patients in which both CAD/CAM and conventional splints present were included. The outcome assessed was accuracy of splints. The risk of bias in clinical trials was assessed using the Cochrane Collaboration tool. The meta-analysis was conducted using the RevMan software V.5.4. The outcome was estimated using weighted average difference and 95% confidence intervals (CIs). The studies’ heterogeneity was assessed using Cochrane’s heterogeneity test (I² Test). Results: A total of six articles fulfilling the inclusion criteria w.ere included, out of which four were included in quantitative synthesis. Accuracy of splints was analysed in a total number of 203 patients. It was found that the CAD/CAM splints were more accurate in comparison to conventional splints. However, this difference was not statistically significant. Conclusions: In this systematic review and meta-analysis, we assessed the accuracy of CAD/CAM splints in comparison with conventional splints among orthognathic patients and we found no significant difference with any point in three planes Frankfort horizontal, coronal and sagittal in the meta-analysis, but the position of the diamond in the forest plot is closer to the CAD/CAM side, thus, favouring the prototype 3D-printed (CAD/CAM) splints, even though non-significant. REGISTRATION: PROSPERO (CRD42023461941).