Accuracy of Dynamic Navigation Systems in Implant Surgery and Prosthetic Outcomes

Abstract

Background:

 Precise implant positioning is essential for achieving favorable prosthetic outcomes, minimizing complications, and ensuring long-term implant success. Dynamic navigation has emerged as an advanced computer-assisted technology that enables real-time guidance during implant placement and may improve surgical accuracy compared with the conventional freehand technique.

Aim:

To compare the accuracy of dynamic navigation-guided implant placement with the conventional freehand technique and to evaluate their influence on prosthetic outcomes, complications, marginal bone loss, implant survival, and patient satisfaction.

Materials and Methods:

This comparative clinical study included 40 patients requiring implant-supported rehabilitation, with a total of 58 dental implants. Twenty-nine implants were placed using a dynamic navigation system, while 29 implants were inserted using the conventional freehand technique. Implant placement accuracy was assessed by measuring coronal, apical, angular, and depth deviations using postoperative CBCT analysis. Primary implant stability was evaluated using the Implant Stability Quotient (ISQ). Prosthetic outcomes included prosthetic alignment, emergence profile, requirement for angled abutments, prosthetic complications, and marginal bone loss. Surgical complications implant survival, patient satisfaction, and correlations between implant placement deviations and prosthetic outcomes were also evaluated. Statistical analysis was performed using independent samples t-tests, Chi-square/Fisher's exact tests, and Pearson's correlation analysis, with statistical significance set at p < 0.05.

Results:

The Dynamic Navigation Group demonstrated significantly lower coronal (0.72 ± 0.24 vs. 1.31 ± 0.43 mm), apical (0.91 ± 0.31 vs. 1.67 ± 0.52 mm), angular (2.18 ± 0.86° vs. 5.14 ± 1.72°), and depth deviations (0.64 ± 0.27 vs. 1.08 ± 0.39 mm) than the Conventional Freehand Group (all p < 0.001). Ideal prosthetic alignment (89.7% vs. 62.1%; p = 0.014), ideal emergence profile (86.2% vs. 65.5%; p = 0.035), and reduced requirement for angled abutments (6.9% vs. 27.6%; p = 0.037) were significantly better with dynamic navigation. Marginal bone loss was significantly lower in the Dynamic Navigation Group (0.48 ± 0.21 mm vs. 0.64 ± 0.32 mm; p = 0.029), while overall patient satisfaction was significantly higher across all evaluated domains (p < 0.05). Implant survival was excellent in both groups (100.0% vs. 96.6%; p = 1.000), and no significant differences were observed in primary implant stability, surgical complications, or prosthetic complications. Significant negative correlations were observed between implant placement deviations and prosthetic outcome scores, with angular deviation demonstrating the strongest correlation (r = −0.614, p < 0.001).

Conclusion:

Dynamic navigation-guided implant placement provides significantly greater positional accuracy than the conventional freehand technique, resulting in improved prosthetic alignment, emergence profile, marginal bone preservation, and patient satisfaction. Although implant survival, primary stability, and complication rates were comparable between the techniques, the enhanced precision achieved with dynamic navigation supports its use as a reliable approach for predictable prosthetically driven implant placement.