Learning sequence may slightly affect the novice practitioners but not experienced ones
SAFH, memory retention, IAFH
GROUP B
This study found that the coronal and apical distance and the angular deviations showed no significant difference between Group IASG vs. IBSG and Group IAFH vs. IBFH. The coronal and apical distance deviation showed no significant difference between Group SASG vs. SBSG and Group SAFH vs. SBFH. The angular deviation was significantly lower in SBFH than SAFH, and not significantly different between SASG and SBSG.Implant placement in a precisely planned position requires abundant experience. Thus, a learning curve is inevitable.For novice students, performing implant placement may have a skill acquisition and memory retention effect even after a washout period of a few days. For Group B, performing the surgical guide approach first may still achieve a relatively good accuracy even at first try due to the template guidance. This initial experience gaining of implant bed preparation and insertion, the familiarity of the drilling sequence and the hand feeling of the bone quality, might benefit the later freehand surgery to some extent. On the contrary, for Group A, the initial trial was freehand implant placement without any physical guidance nor clinical experience, thus leading to the slightly higher angular deviation compared with the accuracy of freehand implant placement in Group B. The crossover design of this study could just identify and analyze the effect of learning sequence.