Review of existing literature and the necessity of the study
angulation
Appropriate three-dimensional (3D) positioning of dental implants is a crucial factor for the long-term success of implant therapy. It ensures good implant stability, bone and soft tissue support, and optimal prosthesis design, in terms of function, aesthetics, occlusion, loading transfer and hygiene maintenance accessibility [Experienced implant surgeons may achieve a relatively high accuracy in the position, depth, and angulation for simple implant placement after a long-term extensive training and practice. However, for novice practitioners, such as dental students without any previous implant placement experience, achieving predictable implant placement based on anatomical structures and the prosthetic requirements can be a great challenge [Dental implant educators have been continuously seeking effective methods for assisting novice practitioners to perform implant placement competently and accurately [The cone beam computer tomography (CBCT) and computer-aided virtual design software are widely utilized tools that provide clinicians, particularly novice practitioners, a clear understanding of bone shape, implant selection, and placement design. Surgical templates can be designed by incorporating the superimposed CBCT data and optical surface scanning data into the guided surgery software. Numerous previous studies have shown that the use of surgical templates can significantly reduce discrepancies between planned and actual implant positions, compared to freehand implant placement [A previous study of our team demonstrated that the novel digital registration method yielded comparable results, and overcame the disadvantages associated with radiation exposure and artifacts when evaluating the accuracy of implant positioning, in contrast to the conventional CBCT method [However, no randomized crossover studies with a sufficiently large sample size were identified that further validated the digital registration method in the accuracy assessment of implant placement with versus without a CAD/CAM surgical guide. Additionally, there is a lack of analysis on the impact of different practitioners’ experience and learning sequence, particularly in the evaluation of simulation model training.