Accuracy of Computer-Guided Dental Implant Placement: A Clinical Comparison of Three Surgical Guide Types

Background/Objectives: The accurate and prosthetically driven placement of dental implants is crucial for long-term clinical success. While computer-aided static navigation enhances precision, the comparative accuracy of different surgical guide support types (teeth-, mucosa-, and bone-supported) under identical clinical conditions remains a critical and less explored variable. This study aimed to compare the accuracy of these three guide types. Methods: This clinical study evaluated the precision of computer-aided implant placement by comparing planned versus actual implant positions in fifty participants who received 140 implants. Discrepancies were measured in 3D using STL files in Exocad^® DentalCAD software (exocad Elefsina 3.2, Darmstadt, Germany). Results: In the maxilla, mean total deviation was 0.443 mm at the implant neck and 0.562 mm at the apex. In the mandible, deviations were higher: 0.755 mm at the neck and 0.981 mm at the apex. Teeth-supported guides demonstrated the highest accuracy. Mucosa-supported guides showed the least precision, particularly in the mandible, while bone-supported guides provided clinically acceptable results. Conclusions: Computer-aided static navigation is highly accurate for implant placement. Guide selection should be tailored to anatomical conditions, with bone-supported guides preferred for edentulous mandibles.