Accuracy comparison of 3D printed tooth-supported implant surgical guides: A prospective observational clinical study

Implant-supported prostheses provide a reliable method of replacing missing teeth. To avoid complications, their accurate placement is critical. Advances in static computer-aided implant surgery (sCAIS), which uses 3-dimensional (3D) imaging and printing, have improved implant placement accuracy. However, whether the location of supporting teeth (anterior versus posterior; maxilla versus mandible) influences accuracy has not been fully explored.

The purpose of this prospective observational clinical study was to assess the accuracy of 3D printed, tooth-supported implant surgical guides in both the anterior and posterior regions of the maxilla and mandible.

A total of 67 participants (116 implants) were included, with preoperative cone beam computed tomography (CBCT) and intraoral scans used to plan implant positions. Printed surgical guides were used for implant placement, and deviations (entrance, apical, depth, and angular) were measured postoperatively. Implant deviations were analyzed using mixed-effects models with patient intercepts and Holm-Bonferroni-adjusted tests.

No significant differences in accuracy were found between the anterior and posterior regions or between the maxilla and mandible (P>.05). The mean deviations were similar across entrance, apical, depth, and angular parameters. Apical deviation exhibited the highest inaccuracy, while depth deviation showed the least variation across all regions. The maxilla showed the most notable deviation in the mesiobuccal direction and the least deviation in the mesiolingual direction (P=.029), while other regions showed no statistically significant differences (P>.05).

Printed, tooth-supported implant surgical guides demonstrated high accuracy across all regions, with apical deviation as the main source of inaccuracy.