Exploring Clinical Decision-Making in Static Computer-Assisted Guided Implant Placement: A Survey of Clinicians in...

Static computer-assisted guided implant placement (sCAIP) has been shown to enhance accuracy and predictability; however, little is known about the multifactorial decision-making processes impacting use among clinicians.

An exploratory cross-sectional electronic survey was distributed to implant practitioners across Australia and New Zealand, including general dentists and specialists (periodontists, prosthodontists, oral surgeons, and oral and maxillofacial surgeons) involved in implant placement. Items covered demographics, training profiles, clinical experience, utilisation patterns, and attitudes towards sCAIP, with free-text reflections. Quantitative data were analysed using descriptive statistics, factor analysis, and t-tests; qualitative data underwent thematic analysis.

Thirty-three respondents completed the survey, with 90.9% reporting current use of sCAIP. Sixteen respondents (48.5%) were classified as analytical decision-makers and 17 (51.5%) as intuitive. Factor analysis identified seven components that explained 84.2% of the variance in decision-making, including surgical complexity and soft tissue conditions, case timing, aesthetic site sensitivity, cost, anatomical risk, training exposure, and clinical experience. Internal consistency across items was high (Cronbach's alpha, α = 0.95). Analytical decision-makers placed significantly more weight on anatomical risk and bone quality compared to intuitive decision-makers (p = 0.038, d = 0.93). Intuitive decision-makers reported higher levels of training exposure (p = 0.04, d = 0.80). Thematic analysis revealed three key influences on sCAIP use: clinician capability, surgical planning and risk mitigation, and restorative outcomes. In addition, several barriers were identified including financial cost, workflow integration, and attitudinal factors.

Clinicians with an analytical decision-making style placed greater emphasis on anatomical risk and were more likely to adopt sCAIP in complex or high-risk cases. Because intuitive clinicians reported higher training exposure, education alone did not explain these patterns, indicating that cognitive style and risk appraisal are central determinants of sCAIP adoption.