Limitations and future perspectives
This study was performed in vitro utilizing simulated models and dental dummies. Despite of the advancements in materials to mimic more realistic artificial gingiva and alveolar bone, the simulation model in a dental dummy was still unable to perfectly simulate real surgical conditions as human or animal cadavers. Besides, the high costs of surgical guide manufacturing, the demand for accuracy in laboratory production and patients’ desires could limit its application in training programs and clinical practice.In addition, the sample size of the instructors’ group was relatively small compared to that of the students’ group in this study, due to the fact of limited availability of experienced instructors. A larger sample size of experienced practitioner group and a multi-center trial may improve the reliability and effectiveness of the study.Moreover, this study only compared the accuracy of implantation between the static surgical guide approach and freehand approach by practitioners with different experience. A more comprehensive comparison among static guide, dynamic navigation and freehand approach by novices and specialists, in terms of the accuracy, time, cost and learning curve are still required. The efficiency and efficacy assessment of the digital registration method in clinical practice is also needed in the future.