The accuracy of single-tooth implants placed using fully digital-guided surgery and freehand implant surgery

Aim: This randomized controlled clinical trial (RCT) aimed to compare the accuracy of implant positions between static computer-assisted implant surgery (CAIS) and freehand implant surgery in a single edentulous space.

Materials and methods: Sites with single edentulous spaces and neighbouring natural teeth were randomized into static CAIS or freehand implant surgery groups. In both groups, digital implant planning was performed using data from cone beam computed tomography (CBCT) and surface scans. In the static CAIS group, a surgical guide was produced and used for fully guided implant surgery, while in the freehand group, the implants were placed in a freehand manner. Postoperative CBCT was used for nine measurements representing the deviations in angles, implant shoulders and apexes between planned and actual implant positions.

Results: Fifty-two patients received 60 single implants. The median (IQR) deviations in angles, shoulders and apexes were 2.8 (2.6)°, 0.9 (0.8) mm and 1.2 (0.9) mm, respectively, in the static CAIS group, and 7.0 (7.0)°, 1.3 (0.7) mm and 2.2 (1.2) mm, respectively, in the freehand group. Statistically significant differences were found in 6 out of nine measured parameters using Mann-Whitney U test (p < 0.05).

Conclusion: Static CAIS provided more accuracy in implant positions than freehand placement in a single edentulous space.