Can a novice dentist, using a dynamic navigation system, achieve the accuracy of experts using freehand implant placement? a retrospective study

BACKGROUND: This study aimed to compare the placement accuracy of a single posterior implant achieved by a novice dentist using dynamic navigation with that achieved by experts using a freehand technique and to analyze the factors influencing the accuracy. METHODS: Patients who underwent implant placement by a novice dentist using a dynamic navigation system (DNS) and three experts using a freehand technique were included. Preoperative and postoperative measurements were recorded to assess the platform, apical, and angular deviations in implant placement. The effects of age, sex, implant position, length, diameter and bone augmentation (guided bone regeneration, GBR) on accuracy were analyzed using a linear regression model. Additionally, patient satisfaction in the two groups was evaluated. RESULTS: The DNS and freehand groups included 28 patients (28 implants) and 30 patients (30 implants), respectively. The DNS group showed a significantly lower angular deviation (3.92 ± 2.33°) compared to the freehand group (7.68 ± 3.53°) (P < 0.001). No notable difference was observed in linear deviations between the groups. However, in a linear regression model, apical deviation was significantly different between the groups (P < 0.05), and platform deviation was significantly correlated with sex, and the use of GBR showed significant associations with certain accuracy parameters (P < 0.05). Patient satisfaction was not significantly different between the groups. CONCLUSIONS: Within its limitations, this study showed that the novice dentist using dynamic navigation achieved better accuracy for posterior single-tooth implant placement than that achieved by experts using a freehand technique, particularly in angular deviation.