Computer guided versus freehand dental implant surgery: Randomized controlled clinical trial

Abstract

Objective

This study compares, in terms of rehabilitation and recovery, freehand implant placement using flapless or mini-flap procedures with the use of 3D implant design software and specialized surgical templates among patients who are partially or completely edentulous. A secondary aim is to propose an algorithm for predicting the accuracy of implant placement. Method.

Patients with an alveolar height of at least 7 mm and an alveolar width of at least 4 mm were randomly assigned to two groups. Group I comprised ten patients who received computer-guided dental implant placement, while Group II comprised ten patients who received manual placements. A temporary prosthodontic was immediately inserted onto the implants, which was replaced by a permanent one after 4–6 months.

Results

The study enrolled twenty patients. A blinded, independent assessor evaluated the outcome variables, which included implant failure, marginal bone loss, treatment duration, post-surgical pain and swelling, use of painkillers, surgical time, and patient satisfaction. Pain scores in Group II were significantly higher than those in Group I, but there were no other significant differences. All patients experienced pain after 2 days, but by 7 days, only two patients in Group I and four patients in Group II were still suffering, although this difference was not statistically significant. After 14 days, all patients were asymptomatic.

Conclusion

Although the freehand technique is straightforward for experienced surgeons, surgical guides enhance the accuracy of implant placement, particularly in a deficient alveolar ridge.