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Dynamic navigation-guided palatal offset for anterior maxillary implants: a randomized controlled trial.

Jia Chen¹, Honghong Liu¹, Yingying Zhang¹

¹Department of Stomatology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

|July 11, 2026

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The palatal offset drilling strategy for dental implants did not significantly improve placement accuracy but notably enhanced initial implant stability. This technique is clinically useful for guided surgery in the anterior maxilla.

Area of Science:

Oral and Maxillofacial Surgery
Dental Implantology
Biomechanical Engineering

Background:

Uneven bone density in the maxillary anterior region can cause labial deviation during dental implant placement.
Standard drilling techniques may struggle to compensate for these anatomical challenges, potentially affecting implant stability and accuracy.

Purpose of the Study:

To assess the clinical effectiveness of a palatal offset drilling strategy in mitigating labial deviation during implant placement.
To evaluate the impact of this strategy on initial implant stability (ISQ) in the maxillary anterior region.

Main Methods:

A randomized controlled trial involving 31 patients (39 sites) comparing standard preparation with a palatally shifted entry (offset) technique.
Implant deviations and implant stability quotient (ISQ) were measured and analyzed using linear mixed-effects models (LMMs).

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Main Results:

No significant differences were found between groups in overall implant placement accuracy (entry-point, apex deviations, angular errors).
The palatal offset group showed a significantly higher initial implant stability quotient (ISQ) compared to the control group (67.05 vs 57.39, P < .001).

Conclusions:

The palatal offset drilling strategy, while not significantly reducing absolute deviation, maintains surgical precision and shows a trend toward reduced labial skidding.
This technique significantly improves initial implant stability, proving valuable for navigated osteotomy in challenging anterior maxillary sites.