Guided Versus Freehand Dental Implant Placement : Where We Stand ? A Narrative Review Based on a Systematic Literature Search

Article Article scientifique Revue de la littérature Guided Versus Freehand Dental Implant Placement : Where We Stand ? A Narrative Review Based on a Systematic Literature Search eng 2026-05-19 2026-05 author Shabana Hamzah 920696 author Markovic Lobo 938440 author Di Felice Roberto author Lombardi Tommaso 22312 author Perez Alexandre 633750 CUMD - Enseignement de chirurgie orale et implantologie (ECOIM) 5071 10.3390/app16105071 2076-3417 https://www.mdpi.com/2076-3417/16/10/5071 <p>Dental implant placement has evolved from conventional freehand techniques toward digitally guided workflows integrating cone-beam computed tomography (CBCT), computeraided design/computer-aided manufacturing (CAD/CAM), and dynamic navigation systems. Although guided surgery improves positional accuracy, its clinical relevance compared with freehand placement remains debated. This narrative review, based on a systematic and structured literature search following predefined selection criteria, analyzes studies published between 2000 and 2025 comparing guided and freehand implant placement regarding accuracy, survival, complications, biological outcomes, and workflow efficiency. Searches of PubMed/MEDLINE, Embase, and Web of Science identified 40 eligible human clinical studies for qualitative synthesis. Guided placement consistently demonstrated greater positional accuracy, with angular deviations of approximately 2–4◦ versus 5–9◦ for freehand placement and linear deviations reduced by about 1 mm. Nevertheless, implant survival rates were high and comparable for both techniques, generally exceeding 95% across short- and medium-term follow-up. Overall complication rates were low; guided approaches reduced anatomical risk and improved prosthetic predictability in complex or multi-implant cases, while freehand placement allowed greater intraoperative flexibility and tactile feedback, potentially optimizing primary stability in variable bone conditions. Marginal bone loss and peri-implant tissue outcomes were similar between approaches. Guided workflows required additional planning time and costs but enhanced reproducibility in complex rehabilitations. Guided and freehand implant placement should therefore be considered complementary strategies, with optimal outcomes depending on case selection, surgical expertise, and the balanced integration of digital technologies into contemporary implant practice.</p> Dental implants Guided surgery Freehand implant placement Dynamic navigation Surgical accuracy Implant survival Prosthetic outcomes Peri-implant tissue Workflow efficiency Digital dentistry Dewey 617.6 Dewey 617 214 Enseignement de chirurgie orale et implantologie 24R 57 Département de chirurgie 222 false 238 Groupe Lombardi Tommaso (médecine dentaire) 313 Applied sciences 16 10 99d144b2-3af4-4b3c-bf73-a2969f814efb Article (Published version) Public applsci-16-05071.pdf 1429028 application/pdf CC BY-4.0 25ebc8db0068a668a0269d0870701a61c1e4d381d8ee61a1908260c2c9dfa977 openAccess Faculté de médecine / Section de médecine dentaire / Enseignement de chirurgie orale et implantologie Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Guided Versus Freehand Dental Implant Placement : Where We Stand ? A Narrative Review Based on a Systematic Literature Search	Applied sciences			2026	56	313

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