Abstract
OBJECTIVE: This study aimed to assess the surgical performance, learning curves, and subjective perceptions of undergraduate dental students using freehand, static, and dynamic computer‐assisted implant surgery (freehand-CAIS, s-CAIS, and d-CAIS) to place implants. METHODS: Twelve undergraduate dental students were enrolled in this study. All of the students completed implant procedures in mandibular models utilizing freehand-CAIS, s-CAIS, and d-CAIS. Each surgical approach was repeated five times, with two implants (left central incisor and left first molar, 31 and 36) inserted each time. Surgical time and implant trueness were used to analyse the students' surgical performance and learning curves for the three surgical approaches. Furthermore, following each surgical approach, students were required to complete the relevant self-assessment surveys. RESULTS: The 12 students successfully placed 360 implants. The surgical time significantly decreased over the first two and first three trials for freehand-CAIS and d-CAIS, and both significantly decreased again in the fifth trial. While the surgical time of s-CAIS significantly decreased over the first three trials and then plateaued. However, the implant trueness of the three surgical approaches did not improve across trials. The surgical time for d-CAIS was significantly longer than that for s-CAIS and freehand-CAIS (P < 0.001). The implant trueness of d-CAIS and s-CAIS was significantly better than that of freehand-CAIS. The global apical deviation (P < 0.01) and angular deviation (P < 0.001) for d-CAIS were significantly lower than those for s-CAIS. Students reported significantly increased self-confidence with implant placement using s-CAIS (P < 0.001) and d-CAIS (P = 0.020). CONCLUSION: Both dynamic navigation and static guides can improve students' implant trueness and self-confidence in implant placement. The surgical speed of students improved significantly over the first two attempts using freehand-CAIS, and within the first three attempts using d-CAIS and s-CAIS. Moreover, the surgical speed of s-CAIS reached a plateau after the third attempt. In terms of implant trueness, dynamic navigation exhibited superior performance in angular deviation control. However, due to the complex workflow of the dynamic navigation system and the consideration of students’ acceptance of this technique, we recommend scheduling training in the d-CAIS approach after training in the freehand-CAIS and s-CAIS in the teaching curriculum. TRIAL REGISTRATION: Clinical trial number: not applicable.