Accuracy of Static Computer-Assisted Immediate and Delayed Anterior Implant Placement by Novice Clinicians

The aim of this study was to compare the accuracy of immediate and delayed implant placements using fully guided (FG) and pilot-guided (PG) static computer-assisted implant surgery (sCAIS) protocols against the freehand (FH) technique in the anterior maxilla by novice implant clinicians.

Fourteen clinicians new to implant dentistry inserted implants in fresh extraction socket (FES) and healed ridge (HR) maxillary central incisor sites of training models. Every clinician inserted an implant per site according to each protocol. The FG protocol involved guided drilling and implant placement. The PG protocol involved guidance of the pilot drill only. The FH protocol used a vacuum-formed surgical template. Deviations in angle, vertical position, and horizontal position at the implant platform and apex were calculated.

The FG protocol demonstrated superior accuracy in terms of horizontal platform and apex deviations across both FES and HR sites. All three protocols showed similar magnitudes of vertical and angle deviations in the FES site. The PG and FH protocols were generally comparable in accuracy. Implant accuracy was broadly similar between FES and HR sites for the FG protocol. Greater accuracy was observed in the FES site compared to the HR site with the FH protocol. For the PG protocol, vertical and angle deviations were greater at the HR site, while platform deviation was greater at the FES site.

Among novice implant clinicians, the FG protocol was superior to the PG and FH protocols and was not significantly influenced by the timing of implant placement. The accuracy of the PG and FH protocols was similar, but likely to be influenced by the timing of implant placement and ridge healing status.