Wearable Augmented Reality for Dental Implant Navigation: From Experimental Models to Clinical Application-A Scoping Review.

Background

Accurate three-dimensional positioning of dental implants is fundamental for long-term prosthetic success. While static guided surgery and traditional dynamic navigation present intrinsic limitations related to physical bulk or hand-eye coordination (the "look-away" phenomenon), Augmented Reality (AR) via Head-Mounted Displays (HMDs) promises to overcome these barriers by superimposing virtual holograms directly onto the surgical field.

Objectives

The aim of this scoping review is to map the existing literature to evaluate the positioning accuracy, workflow efficiency, and ergonomic/technical barriers of HMD-based AR navigation systems in implant dentistry.

Methods

A systematic search was conducted across the PubMed, Scopus, Web of Science, and Cochrane Library databases, following the PRISMA-ScR guidelines. In vitro, ex vivo, and clinical studies utilizing AR headsets (e.g., HoloLens) for implant guidance, reporting quantitative data on accuracy and/or qualitative data on usability issues, were included.

Results

Eleven studies were included (7 in vitro, 1 ex vivo, 3 clinical). Accuracy showed a strong dependence on case complexity: for standard implants, the mean error at the entry point ranged between 0.33 and 1.51 mm, which is comparable to s-CAIS techniques. However, in complex scenarios (zygomatic implants), significant deviations were reported (up to 5.64 mm and 9.60°). The main barriers to routine adoption identified include tracking instability due to line-of-sight interruption, device weight, and the vergence-accommodation conflict.

Conclusions

AR dynamic navigation demonstrates promising potential. Nevertheless, current evidence relies predominantly on in vitro studies that fail to fully replicate real-world surgical complexities. Persistent technical and ergonomic barriers, such as tracking instability and hardware limitations, indicate that the technology remains largely in a preclinical phase and is not yet suitable for routine clinical application. Further advancements toward markerless tracking systems, lighter headsets, and rigorous in vivo trials are required.