Accuracy of Static Computer-Guided Versus Freehand Implant Placement Using Intraoral Scanner-Based Digital Workflow - A Clinical and Radiographic Study

Q: What was the purpose of this randomized clinical trial?

To compare implant placement accuracy, surgical efficiency, and patient discomfort between static computer-guided surgery and conventional freehand implant placement.

Q: What outcomes favored the guided surgery group?

The guided group showed higher placement accuracy with lower mean angular and linear deviations, shorter surgery time, and lower post-operative pain scores on Day 1 and Day 3.

Sep 30, 2026

Uploaded by anakgang17

Digital technologies are increasingly used in implant dentistry, enabling static computer-guided surgery. A clear comparison with conventional freehand placement requires evidence on accuracy and patient-reported outcomes. This randomized clinical trial compared implant placement accuracy, surgical efficiency, and patient discomfort between static computer-guided and freehand techniques in thirty partially edentulous patients.

LanguageEnglish

CategoryHealthcare

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Abstract

Background

Aim

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Materials and Methods

Original Research Accuracy of Static Computer‑Guided Versus Freehand Implant Placement Using Intraoral Scanner‑Based Digital Workflow: A Clinical and Radiographic Study Jeemee Patel1, Arunkumar Jayaraman2, Renuka Devi Arumalla3, Roshan Arbaaz B4, Nihal Ahamed A4, Parthiban Saketh Raman4, C Pradeep5 1Department of Oral and Maxillofacial Surgery, Siddhpur Dental College and Hospital, Dethali, Gujarat, India, 2Department of Oral and Maxillofacial Surgery, Vinayaka Missions Sankarachariyar Dental College, Ariyanoor, Salem, Tamil Nadu, India, 3Department of General Dentistry, Sibar Dental College, Takkellapadu, Guntur, Andhra Pradesh, India, 4Department of Periodontics, Sri Venkateshwaraa Dental College, Ariyur, Pondicherry, India, 5Department of Prosthodontics and Oral Implantology, Private Practitioner, Tamil Nadu, India Submitted: 07‑Aug‑2025 Revised: 20‑Aug‑2025 Accepted: 25‑Aug‑2025 Published: 17‑Dec‑2025 Abstract Background: The increasing use of digital technologies in implant dentistry has led to the development of static computer‑guided surgery. However, a clear comparison between the accuracy and patient‑reported outcomes of this method versus conventional freehand techniques is needed.Aim: This randomized clinical trial aimed to compare the accuracy of implant placement, surgical efficiency, and patient discomfort between static computer‑guided surgery and freehand implant placement. Methods: Thirty partially edentulous patients were randomly assigned to either a guided surgery group (Group A, n = 15), where implants were placed using a 3D‑printed surgical guide based on an intraoral scan and CBCT, a freehand group (Group B, n = 15), where implants were placed conventionally. The primary outcome was implant placement accuracy, measured by angular and linear deviations between the planned and final implant positions. Secondary outcomes included surgery duration and patient‑reported pain scores (VAS) . Statistical analysis was performed using independent t‑tests and the Mann‑Whitney U test, with a significance level of P < 0.05. Results: The guided group demonstrated significantly higher accuracy, with lower mean angular deviation (2.4 ± 1.2 vs. 6.8∘ ± 2.1, P < 0.001) and linear deviations at both coronal (0.7 ± 0.3 mm vs. 1.9 ± 0.6 mm, P < 0.001) and apical levels (1.1 ± 0.4 mm vs. 2.5 ± 0.9 mm, P < 0.001). Furthermore, Group A had a shorter mean surgery time (28.4 ± 4.2 mins vs. 39.7 ± 5.3 mins, P < 0.001) and lower post‑operative pain scores on Day 1 and Day 3 (P < 0.001) . Conclusion: Static computer‑guided implant surgery provides superior accuracy, enhances surgical efficiency, and results in a more comfortable post‑operative experience for patients compared to conventional freehand techniques. The findings support the use of a digital workflow for predictable implant placement. Keywords: Cone‑beam computed tomography, oral surgery, static computer‑guided implant surgery Introduction Dental implantology has undergone a significant transformation with the advent of digital technology, transitioning from traditional methods to a more predictable, computer‑aided approach. The integration of Cone‑Beam Computed Tomography (CBCT) for detailed anatomical assessment and intraoral scanners for precise digital impressions has created a streamlined | Access this article online | | | --- | --- | | Quick Response Code:
| Website: [https://journals.lww.com/jpbs](https://journals.lww.com/jpbs) | | | DOI: 10.4103/jpbs.jpbs_1396_25 | workflow for implant treatment planning.[1] This digital process culminates in the fabrication of a 3D‑printed | Address for correspondence: Dr. Jeemee Patel,
Department of Oral and Maxillofacial Surgery, Siddhpur Dental College and Hospital, Dethali, Gujarat, India.
E-mail: [jeemee.patel2223@gmail.com](jeemee.patel2223@gmail.com) | | --- | | This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDe

FAQs

What was the purpose of this randomized clinical trial?

To compare implant placement accuracy, surgical efficiency, and patient discomfort between static computer-guided surgery and conventional freehand implant placement.

How were patients assigned to groups and what did each group receive?

Thirty partially edentulous patients were randomly assigned to Group A (guided surgery using a 3D-printed guide from intraoral scan and CBCT) or Group B (conventional freehand placement), with 15 patients in each group.

What outcomes favored the guided surgery group?

The guided group showed higher placement accuracy with lower mean angular and linear deviations, shorter surgery time, and lower post-operative pain scores on Day 1 and Day 3.

Sep 30, 2026

Uploaded by anakgang17