Beyond Accuracy: Clinical Outcomes of Computer Assisted Implant Surgery

Objectives: Computer Assisted Implant Surgery (CAIS) with different technologies and modalities is becoming increasingly utilized in clinical practice. The aim of this White Paper was to synthesize evidence, reported experience, and best practices with regard to clinically relevant outcomes of static, dynamic, and robotic CAIS. Materials and methods: A review of the literature compiled existing evidence from clinical studies up to November 2024, which was later discussed and synthesized into clinically relevant questions with a panel of international experts. Results: There is overwhelming evidence for the superiority of static, dynamic, and robotic CAIS with regard to the accuracy of implant placement and some limited evidence of superior esthetic outcomes. At the same time, outcomes related to implant primary stability, survival rates, intra- and postoperative complications, marginal bone loss, and peri-implant tissue health appear similar between guided and non-guided implant surgery, while efficiency is poorly defined and studied. The importance of accuracy in the execution of a comprehensive, prosthetically driven treatment plan is not reflected in most studies, which focus mainly on the assessment of procedures rather than entire treatment workflows. Such inherent limitations of available research might conceal some of the potential of guided CAIS. Conclusions: Guided CAIS can achieve at least as good clinical outcomes as non-guided implant surgery. Studies that can assess the benefits of CAIS as part of a treatment workflow, rather than isolated procedures, could improve our understanding of the potential of these technologies.