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BACKGROUND

Accurate three-dimensional dental implant placement is essential for achieving predictable functional, esthetic, and biomechanical outcomes. Digital workflows incorporating static surgical guides, dynamic navigation, and robotic-assisted platforms improve implant placement accuracy. However, reported accuracy varies among these guidance modalities, warranting systematic evaluation.

METHODS

A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Electronic searches of PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar identified clinical studies published between January 2015 and May 2025. Studies reporting angular and linear deviations between planned and actual implant positions were included. Data were extracted for freehand, static guided, dynamic navigation, and robotic-assisted implant placement. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools. Because of clinical and methodological heterogeneity, findings were synthesized narratively.

RESULTS

Eleven clinical studies met the inclusion criteria. Robotic-assisted implant placement demonstrated the lowest angular and linear deviations, with mean entry and apical deviations generally below 1 mm and angular deviations frequently below 2°. Dynamic navigation showed intermediate accuracy, whereas static guided surgery demonstrated slightly greater positional deviations. Freehand implant placement consistently showed the greatest deviations. Accuracy was influenced by anatomical location, guide support type, and operator experience.

CONCLUSION

Guided implant placement techniques provide greater accuracy than freehand approaches. Within the available evidence, robotic-assisted systems demonstrated the lowest reported deviations, followed by dynamic navigation and static guided surgery. Guidance modality should reflect clinical complexity, anatomical considerations, and available resources.

SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03250-y.