Examining the Influence of Freehand, Pilot-Guided, and Fully Guided Surgical Protocols on the Accuracy of Immediately Placed Implants—An In Vitro Study

This study aimed to evaluate the influence of the guidance level on the accuracy of immediately placed implants. Methods: Eighteen identical maxillary models (randomly split into three groups (n = 6): fully guided (FG), pilot-guided (PG), and freehand (FH)) were used to place 72 implants (n = 24). After placement, the mean global, angular, mesial–distal, buccal–palatal, and vertical deviation at the platform and apex of the placed implants, relative to the preoperatively planned positions, was calculated. Results: Significant differences in global and mesial–distal deviation were found between implants in the FG group and implants in the PG and FH groups. Significant differences were also found between the implants in the FG and FH groups as well as the implants in the PG and FH groups in terms of angular and mesial–distal apex deviation. Finally, significant differences were found between the implants in the FG and PG groups in terms of buccal–palatal platform deviation. Conclusions: The results of this in vitro study show that immediate implants placed using fully guided surgical guides have significantly less deviation, and are therefore more accurate, than implants placed freehand or using pilot guides, but this should be further validated in a clinical trial.