An In-vitro Analysis of the Accuracy of Different Guided Surgery Systems – They Are Not All the Same

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Source Publication

Clinical Oral Implants Research

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Original Item ID

DOI: 10.1111/clr.14061



Different static computer-assisted implant surgery (sCAIS) systems are available that are based on different design concepts. The objective was to assess seven different systems in a controlled environment.

Materials and Methods

Each n = 20 implants were placed in identical mandible replicas (total n = 140). The systems utilized either drill-handles (group S and B), drill-body guidance (group Z and C), had the key attached to the drill (group D and V), or combined different design concepts (group N). The achieved final implant position was digitized utilizing cone-beam tomography and compared with the planned position. The angular deviation was defined as the primary outcome parameter. The means, standard deviation, and 95%-confidence intervals were analyzed statistically with 1-way ANOVA. A linear regression model was applied with the angle deviation as predictor and the sleeve height as response.


The overall angular deviation was 1.94 ± 1.51°, the 3D-deviation at the crest 0.54 ± 0.28 mm, and at the implant tip 0.67 ± 0.40 mm, respectively. Significant differences were found between the tested sCAIS systems. The angular deviation ranged between 0.88 ± 0.41° (S) and 3.97 ± 2.01° (C) (p < .01). Sleeve heights ≤4 mm are correlated with higher angle deviations, sleeve heights ≥5 mm with lower deviations from the planned implant position.


Significant differences were found among the seven tested sCAIS systems. Systems that use drill-handles achieved the highest accuracy, followed by the systems that attach the key to the drill. The sleeve height appears to impact the accuracy.


Clinical Oral Implants Research, Vol. 34, No. 5 (May 2023): 531-541. DOI.