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

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.