Accuracy of implant placement using surgical guides in edentulous patients: a systematic review and meta-analysis

The success of complete-arch implant-supported prostheses in edentulous patients relies heavily on accurate implant placement using surgical guides. The aim of this study was to assess and compare the accuracy of bone-supported and mucosa-supported guides in dental implant surgery. A comprehensive literature search following the PRISMA guidelines was conducted across PubMed, OVID, MEDLINE, and Scopus for studies published between January 2000 and August 2025. Thirteen articles meeting the inclusion criteria were selected, encompassing a total of 1092 implants-952 placed using mucosa-supported guides and 140 using bone-supported guides. Meta-analysis revealed no significant differences between bone-supported and mucosa-supported guides in angular deviation (4.41° vs 5.43°, P = 0.45), linear deviation at entry (1.46 mm vs 1.64 mm, P = 0.42), or linear deviation at apex (1.59 mm vs 2.13 mm, P = 0.16). Depth deviation was reported only for mucosa-supported guides, with an overall pooled estimate of 1.12 mm. These findings indicate no significant difference in linear deviation (at entry or apex) or angular deviation between bone-supported guides and mucosa-supported guides.