COMPUTER-PLANNED IMPLANT SURGERY: COMPARISON BETWEEN THE USE OF THE SURGICAL GUIDE FOR IMPLANT SITE PREPARATION ONLY OR ALSO FOR IMPLANT INSERTION IN A SINGLE IMPLANT REHABILITATION CASE

¹ Department of Translational Medicine, University of Ferrara

Correspondence to:

European Journal of Musculoskeletal Diseases 2026 September-December 15(3): Ahead of Print
https://doi.org/10.82093/ejmd/2026v15iss3_4

Received: 28 July 2026 Accepted: 2 September 2026

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Abstract

The objective of this study was to evaluate differences in implant placement accuracy between the use of a surgical guide throughout the entire procedure and its partial use, limited to implant-site preparation. This distinction may be relevant in patients with anatomical limitations of the oral cavity and because contact between the guide and implant may compromise sterility. A surgical guide was designed for the rehabilitation of a single tooth and used on a 3D-printed mandible containing polystyrene blocks reproducing type IV bone according to the Misch classification. Three implants with different structural characteristics were evaluated. Each implant was inserted into 10 blocks using the guide throughout the entire sequence, from pilot drilling to implant placement, and into 10 blocks using the guide only during the preparation phases. Each procedure was followed by scanning of the mandible, block, and implant, for a total of 60 scans. Digital measurements were performed to compare the accuracy of the two techniques. The use of the surgical guide throughout all phases of implant placement resulted in greater accuracy than its partial use. Although repeated insertions appeared to improve precision, the fully guided technique provided more consistent accuracy and reduced variability between implant placements. The results suggest that the full digital workflow is less dependent on the operator’s manual dexterity and the type of implant used, whereas partial guide use requires greater operator skill to achieve comparable accuracy. The full digital workflow may facilitate prosthetic planning and reduce the number of steps required for rehabilitation. However, appropriate patient selection remains essential because anatomical limitations may complicate guide and instrumentation use and may pose challenges to maintaining implant sterility. As this was an in vitro study, further clinical investigation is required. Nevertheless, the findings support the prospective advantages of computer-planned, fully guided implant surgery in improving placement accuracy and potentially reducing complications associated with implant positioning.

Keywords: computer-planned implant surgery, dental implant placement accuracy, digital workflow, fully guided surgery, guided implant surgery, partially guided surgery, surgical guide