Analysis of accuracy of four types of fully guided dental implant surgical guides: an in vivo study

OBJECTIVE: This clinical trial was conducted to compare the four types of static fully guided surgical guides (bilateral tooth-supported guides, unilateral tooth-supported guides, mucosa-supported complete arch guides, and stackable bony-supported guides) in terms of accuracy. AIM: To compare all static guided protocols (bilateral tooth supported, unilateral tooth supported, full arch mucosa supported, stackable bone supported) with each other under homogenous conditions, accuracy is defined as the closeness of spatial agreement between any given implant as planned (reference) and as inserted (measurement), expressed by four spatial deviation parameters. METHODS: All patients in this investigation underwent a cone beam computer tomography with standard settings. Meanwhile, digital impressions were taken by an intraoral scanner. Implant planning software was used, considering a prosthetic-driven approach. Fully guided surgeries were executed. To evaluate the four groups of fully guided surgical guides, a digital imprint was obtained immediately after surgery. All STL files were imported into CAD software, and a digital library translated scan bodies to implant fixture replicas. For trueness tests, new STL files were loaded into an inspection program. RESULTS: A single experienced surgeon inserted 86 implants using four different types of fully guided surgical guides. For the angular deviation, the Kruskal-Wallis test showed that there was no significant difference (P=.117). In contrast, for the coronal global and apical global deviations, as well as the vertical discrepancies, there was a statistically significant difference between the four groups (P=.022), (P=.018), (P < .001), respectively. A Dunn-Bonferroni test was used to compare the groups in pairs to identify any significant differences. CONCLUSIONS: Given the limitations of this study, the trueness of the four categories of fully guided surgical guides falls within an acceptable range. Nevertheless, when utilizing mucosa-supported and stackable guides, operators should consider inherent deviations and exercise heightened vigilance. CLINICAL TRIAL REGISTRY DATE: 27. 04. 2025. CLINICAL TRIAL REGISTRY NUMBER: NCT06947057.