A retrospective study of the accuracy of template-guided versus freehand implant placement: A nonradiologic method

Objective. The aim of this retrospective case study was to evaluate implant placement accuracy in inexperienced clinicians with use of a surgical guide template vs the freehand method for preoperatively planned implant position. Study Design. Oral implant therapy was performed by inexperienced dental practitioners (<20 implants placed) on eligible patients after cone beam computer tomography (CBCT)-based software planning. Two patients' groups were formed according to the surgical technique: guided and freehand implant placement. The casts used for the fabrication of reconstructions were scanned by using a 3-dimensional (3D) laser scanner, the implant positions were superimposed with preoperative planning data, and the 3D deviations were calculated. Results. Twenty adult patients were included in this retrospective study (20 guided and 21 freehand implant placements). Mean calculated deviations with use of a surgical guide template were significantly lower compared with those of the freehand method with regard to angulation (P = .002), apical position (P = .002), and basal position (P = .012). No significant differences in implant placement accuracy were detected between the groups according to the implant position (premolars/molars; upper jaw/lower jaw) (P > .05). Conclusions. Computer-aided planning and the use of surgical guides in accordance with CBCT images may help inexperienced clinicians to place implants with high accuracy.