Guided Implant Surgery versus Conventional Implant Placement: A Systematic Review of Accuracy and Complications

Background: One great advantage of guided implant placement over freehand is the ability to plan the implant placement, make precise incisions and predict the outcome of the clinical scenario. Objective: This systematic review aimed to evaluate the accuracy of implant placement and complications of guided implant surgery versus conventional implant placement. Methods: The PRISMA 2020 guidelines were used for the review. Manual reference screening and electronic searches on PubMed and Google Scholar databases were carried out. A total of 241 records were identified and 11 studies of mixed design were included in the qualitative synthesis. Results: The results revealed that the accuracy of implant placement was generally superior for guided implant surgery (static and dynamic computer-assisted systems) than for freehand implant surgery. The guided systems were found to have lesser deviations in the coronal, apical, and angular directions and transfer of digital planning was more in the guided systems. In a few studies, it was also observed that guided surgery had a positive effect on reduced pain and comfort after surgery and reduced complications related to positioning. Nevertheless, there was a correlation between a higher learning curve, technical complexity and procedural cost with the guided implant surgery. Cost, ease of procedure and ease of workflow were all advantages of conventional placement. Conclusion: Guided implant surgery appears to be a reliable and effective method for enhancing implant placement accuracy, although further comparative clinical evidence is required to confirm its effect on surgical complications.