Comparison of Dental Implant Placement Accuracy Using a Static Surgical Guide, a Virtual Guide and a Manual Placement Method - An In-Vitro Study

The use of a surgical guide during pre-operative planning significantly increases the efficiency and safety of dental implantation. However, the current widespread use of static navigation has led to a decrease in accuracy. Dynamic navigation, on the other hand, can be an alternative. This study compared the accuracy of dental implant placement on jaw models using static navigation, a virtual guide and the manual placement method. Nine patients with favourable conditions were selected, and three-dimensional full-body jaw models were set up. Group I had 21 implants placed using static navigation, Group II had 21 implants placed using dynamic navigation and Group III had 21 implants placed using the 'free hand' method. Placement accuracy was calculated by the deviation between the planned implant position and the actual position obtained from post-operative cone-beam computed tomography and model scanning. The deviation from the planned implant position was 0.4° in Group I and 0.5° in Group II. The 'free hand' method yielded the worst result, with a statistically significant difference between Groups I and II. However, implantation using dynamic navigation showed a lower variance of deviation, with the majority of implants having a deviation ≤0.5 mm (86% compared to 67% in the static navigation group). The accuracy of implant positioning using a virtual guide with dynamic imaging was comparable to static navigation and surpassed the accuracy obtained using the 'free hand' technique. This study highlights the potential of dynamic navigation control in dental implantology and warrants further clinical research to improve this system.