Impact of Operator Experience on Accuracy and Procedure Time in Dynamic Navigation, Static-Guided, Freehand Implant Placement: An In Vitro Study.

Dynamic navigation systems offer significant potential to enhance dental implant surgery, particularly for novice surgeons. To compare the accuracy and time consumption of freehand implant surgery (group A), static computer-assisted implant surgery (sCAIS; group B), and dynamic computer-assisted implant surgery (dCAIS; group C) performed by novice and experienced surgeons in vitro. A total of 192 implants (n = 192) were placed in polyurethane mandibular models under simulated clinical conditions by 16 participants, divided into 2 groups. Implants were placed after CBCT-based virtual planning. Postoperative surface scans were superimposed on the preoperative planning data to evaluate the angular and spatial deviations. A linear mixed model analysis, followed by descriptive statistics, was used to determine the influence of experience level, method, and operative site on various accuracy parameters. The applied implant placement methodology showed a statistically significant influence on the angular deviation, the 3D deviation at the base and tip, the bucco-oral and mesial-distal deviation at the implant base (P < .05). The lowest mean angular deviation was recorded in group B with 3.12° (±1.49°). The regions where the implants were placed had a significant influence on the angular deviation parameter (P < .001). The level of experience showed a statistically significant difference in the angular deviation of the placed implants (P < .001) and in the bucco-oral deviation at the implant tip (P = .04). Novice surgeons consistently required significantly more time compared with experienced surgeons. Both CAIS approaches hold potential to improve implant placement outcomes, showing significant improvements over freehand techniques.