Abstract
While virtual planning of implant placement is common, reliable clinical transfer remains critical. This randomized clinical trial compared transfer accuracy between a miniaturized dynamic computer-assisted implant surgery system (dCAIS; DENACAM) and static computer-assisted implant surgery (sCAIS; BEGO). In 45 patients, 70 implants were placed (n = 35 per method). Deviations between planned and achieved positions were assessed by CBCT superimposition. Accuracy differences were analyzed using linear mixed-effects models (Type III F-tests; F, p-value, ICC) for 3D angular, 3D linear (implant base, tip), 2D mesio-distal, vestibulo-oral, and apico-coronal deviations. Ergonomic perception and covariate effects (age, sex, jaw, implant region, gap type) were analyzed using mixed-effects regression (β, 95% CI; α = 0.05). No significant accuracy differences were observed (p > 0.05). ICC values (0.00-0.56) indicated substantial patient-level variance. Mean 3D deviations (dynamic vs. static) were 4.89° ± 2.17 vs. 5.01° ± 2.13 (angular), 1.81 mm ± 0.69 vs. 1.55 mm ± 0.47 (base), 2.01 mm ± 0.72 vs. 1.78 mm ± 0.52 (tip). Ergonomic ratings were comparable. Covariate effects were limited to jaw (2D base deviation) and age (3D angular deviation) (p = 0.022, 0.015). This dCAIS may be equally suitable for implant plan transfer as sCAIS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1038/s41598-026-45931-1.