Does it take more than a static pilot guide to match the accuracy of dynamic navigation? A preliminary randomised study.

Purpose: To compare the accuracy of static guided surgery using a pilot drill guide and dynamic guided surgery for dental implant placement.

Materials and methods: Partially edentulous adult patients requiring implant placement were randomly assigned to either the static guided surgery group using a pilot drill guide or the dynamic guided surgery group. Digital implant planning was conducted using intraoral scans and CBCT with planning software to determine the optimal prosthetic position. Postoperative CBCT scans were taken to compare with the plan and assess platform, apex, vertical and angular deviations from the planned implant positions.

Results: A total of 25 implants were placed. Mean deviations at the implant platform were 1.17 ± 0.75 mm for the static guided surgery group and 1.17 ± 0.71 mm for the dynamic guided surgery group, with no significant differences (P = 0.983). Apical deviations were 2.39 ± 1.22 mm for the static guided surgery group and 1.75 ± 0.59 mm for the dynamic guided surgery group, with no significant differences (P = 0.112). Vertical deviations were 0.79 ± 0.50 mm for the static guided surgery group and 0.61 ± 0.51 mm for the dynamic guided surgery group (P = 0.403). Significant differences were found in angular deviations, with the static guided surgery group showing 10.9 ± 5.63 degrees and the dynamic guided surgery group showing 4.72 ± 2.63 degrees (P = 0.002). Independent variables such as sex, age, implant location, arch and implant size did not significantly influence accuracy.

Conclusion: Both static and dynamic guided surgery offer comparable precision in implant placement, with dynamic guided surgery providing superior angular accuracy. Further studies with larger sample sizes are recommended to validate these findings.

Conflict-of-interest statement: The authors declare there are no conflicts of interest relating to this study.