Discussion
CAIS, angulation
Static CAIS is performed in clinical practice to enable dental implant placement close to the virtually planned, prosthetically desirable position [In the present study, improved implant placement accuracy was observed in models where step drills were used to complete implant bed preparation following the guided pilot osteotomy compared to when straight drills were used. However, different drill designs did not significantly influence the angulation of the implants placed. Therefore, the null hypothesis of the present study was rejected: the design of the drills used to finalize implant osteotomies following pilot-guided sCAIS influences dental implant placement accuracy.Dental implant manufacturers provide surgical trays with drills deemed the most suitable for preparation of the implant bed. In a pilot-guided protocol, only the first osteotomy is guided by the surgical template [In their study, Guentsch et al. reported on the implant placement accuracy achieved using pilot-guided sCAIS. According to their results, an angular deviation of 2.83 ± 0.79°, coronal global deviation of 0.54 ± 0.16 mm, and apical global deviation of 0.97 ± 0.25 mm were found using straight drills to finalize osteotomies [In their study, Kivovics et al. performed pilot-guided sCAIS using step drills to finalize implant placement and reported an angular deviation of 3.21 ± 1.52°, coronal global deviation of 1.31 ± 0.42 mm, and apical global deviation of 1.38 ± 0.41 mm [In their systematic review and meta-analysis, Bover-Ramos et al. reported on the implant positioning accuracy achieved in in vitro studies. According to their results, an angular deviation of 3.13 ± 0.23°, coronal global deviation of 1.00 ± 0.08 mm, and apical global deviation of 1.23 ± 0.10 mm may be expected using fully guided CAIS in in vitro studies [The material and technology used to manufacture surgical templates greatly influences the accuracy of sCAIS. It is paramount to analyse the biomechanical properties (compression and tensile modulus) of the materials used to produce surgical guides and assess their structural changes following compression [According to the literature, fully guided sCAIS provides superior accuracy compared to half-guided and pilot-guided approaches [According to the literature, implant placement accuracy positively correlates with higher bone density [Other factors that influence implant placement accuracy in sCAIS are sleeve height, length of the guided channel, and free drilling distance [The present study has several strengths; the same implant brand with uniform diameter and length was used in all study groups, the technique and material used to manufacture the surgical guides were the same in all study groups, and measures were taken to minimize participant bias. Fully guided implant placement showed better implant positioning accuracy than the pilot-guided approaches in the present study, which supports the evidence in the literature [