Augmented Reality Improves Accuracy of Dynamic Computer-Assisted Implant Surgery: An In Vitro Analysis

To assess the accuracy of dynamic computer-assisted implant surgery (dCAIS) performed with and without augmented reality (AR) smart-glasses visualization under standardized laboratory conditions.

A standardized typodont model with bounded and unbounded edentulous spaces was prepared to receive polyurethane blocks. Five implants were virtually planned using implant-planning software, and the plan was transferred to a miniaturized dynamic navigation system. Forty simulated surgeries (n = 40; total 200 osteotomies) were performed under two conditions: (a) standard screen-based guidance (dCAIS) and (b) smart-glasses guidance (dCAIS+SG) projecting real-time navigation data into the operator's field of view. Postoperative CBCT scans were used to compare planned and achieved osteotomies. The 3D deviation at the crestal level was defined as the primary outcome parameter. Means, standard deviations, and 95% confidence intervals were calculated, and data were analyzed using paired t-tests (trueness and precision).

The mean 3D deviation at the crest was significantly lower with smart-glasses visualization (dCAIS: 0.32 ± 0.17 mm; dCAIS+SG: 0.27 ± 0.16 mm; p = 0.02), primarily due to reduced 2D mesiodistal deviation (0.20 ± 0.16 mm vs. 0.09 ± 0.07 mm; p < 0.0001). Angular deviation remained low and comparable between groups (0.40° ± 0.31° vs. 0.34° ± 0.35°; p = 0.2). Both workflows exhibited similar precision across all parameters.

AR smart-glasses enhanced the trueness of dynamic navigation without affecting precision. Integrating AR into dCAIS enables continuous visualization of navigational data, potentially improving ergonomic workflow and maintaining visual focus on the surgical field.