EVALUATION OF THE ACCURACY AND PRECISION OF TWO STATIC COMPUTER-ASSISTED GUIDED SURGERY SYSTEMS: AN IN VITRO EXPERIMENTAL STUDY

Computer-guided surgery is an established technique in dentistry, with current research focusing on optimizing the three-dimensional positioning of implants to achieve superior esthetic and functional outcomes. The precision of implant placement is a critical factor for long-term success. This study aimed to compare the accuracy of two static guided surgery systems that differ primarily in their drill-guiding method, in an in vitro laboratory simulation. For the study, a mandibular arch model with four missing premolars was created. The surgery was planned using virtual planning software after acquiring images via cone-beam computed tomography and scanning the model. Twenty implants were placed in five models, with ten implants for each system evaluated. Group 1 utilized a system with a guide sleeve and a handle to direct the drills, while Group 2 used a system where the drills were guided directly by the sleeve, without the use of a handle. The final position of the implants was measured by scanning the models after placement and superimposing them with the virtual plan using metrology software. The mean deviations for Group 1 were 0.308 mm (mesio-distal), 0.361 mm (vestibulo-lingual), and 0.449 mm (vertical). The mean deviations observed in Group 2 were 0.119 mm (mesio-distal), 0.398 mm (vestibulo-lingual), and 0.342 mm (vertical). Although both systems demonstrated accuracy compatible with established clinical standards, a statistically significant difference in the mesio-distal deviation (p = 0.006) favored the system without a handle, suggesting that its design may contribute to greater implant positional stability. No statistically significant differences were observed in the vestibulo-lingual and vertical deviations. In conclusion, while both systems demonstrate high accuracy and are clinically acceptable, the static guided surgery system without a handle offers a significant advantage in the precision of mesio-distal implant positioning.