Comparative Trueness of Static, Dynamic, and Robotic Computer-Assisted Implant Surgery: A Comprehensive Umbrella Review

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.