Abstract
BACKGROUND: Digital guided implantology improves safety and precision compared to freehand methods. A survey indicated that half-guided templates are more commonly used than full-guided ones in China. This study aims to assess the accuracy of implant placements using half-guided and full-guided digital surgical templates, considering factors like jaw location, tooth position, support type, implant timing, and bone density. METHODS: 87 implants (52 half-guided, 35 full-guided) were evaluated by comparing pre- and postoperative CBCT scans to measure deviations in coronal, apical, depth, and angular positions. Bone density was also assessed in relation to the implant deviations. RESULTS: The findings revealed that the half-guided group exhibited significantly greater deviations in several areas: maxillary angular deviations, anterior coronal and depth deviations, posterior depth deviations, tooth-supported guide depth deviations, immediate implant coronal and angular deviations, and delayed implant depth deviations (P < 0.05). No significant differences were noted in other measurements. In the bone density analysis, only the full-guided group showed a significant negative correlation between bone density and apical deviation (P < 0.05). CONCLUSION: Based on statistical results, power calculations, and subgroup effect sizes, the following clinical recommendations are derived: Half-guided templates, owing to their superior cost-effectiveness in fabrication time and cost, are recommended for use in mandibular posterior regions, mucosa-supported templates, delayed implantations, and clinical scenarios with uneven bone density distribution at implant sites. In contrast, full-guided templates are more suitable for maxillary implantations, anterior regions, tooth-supported templates, immediate implantations, and sites with homogeneous bone density distribution.