Accuracy of dynamic computer-assisted implant surgery across different degrees of edentulism: does experience matter? An in vitro study

To evaluate the accuracy of a dynamic computer-assisted implant surgery (dCAIS) system utilized by two clinicians with differing levels of surgical experience in implant dentistry. A total of 72 conical dental implants were placed into 18 jaw models using a dCAIS system (Navident, ClaroNav, Toronto, Canada). Implant planning and placement were performed by both a novice and an experienced implantologist, following a standardized protocol across single-tooth gaps, shortened dental arches, and fully edentulous jaws. Pre- and postoperative CBCT scans were aligned, and deviations were analyzed at the coronal entry point (2D), apex (3D), apex vertically (V) and in angular deviation (°). Level of significance was set at p < 0.05. Mean deviations across all implants placed were: 1.25 ± 0.90 mm at entry point (2D), 1.66 ± 0.68 mm at apex (3D), 0.70 ± 0.51 mm at apex (V) and 4.96 ± 3.16° angular. No statistically significant differences were found between clinicians, jaws, or sides (p > 0.05). However, a significant correlation was observed regarding accuracy at entry points and angular deviations, indicating lower accuracy in fully edentulous jaws (p < 0.05). The investigated dCAIS system enabled accurate transfer of the planned to the actual (in vitro) implant position independent of operator experience. dCAIS systems may help mitigate the impact of limited surgical experience and contribute to more predictable outcomes. However, reduced anatomical reference points in edentulous jaws justify further clinical investigation and workflow optimization.