Impact of clinician experience on the accuracy of static guided implant placement in post-extraction sockets: a cadaver study
To evaluate the accuracy of s-CAIS in immediate post-extraction sockets using a cadaver model and to assess whether operator experience influences implant placement precision and surgical time. Twenty teeth (incisors: 9; premolars: 8; molars: 3) were extracted from two fresh defrozen cadaver heads, and implants were planned using a digital workflow integrating cone beam computed tomography and intraoral scanning. Custom-made tooth-supported surgical guides were fabricated and used by two operators: one expert (> 5 years of experience) and one non-expert (< 5 years of experience), both without prior guided surgery experience. Twenty implants were placed. Post-operative scans were taken and superimposed to the pre-operative plans to measure global head deviation, global tip deviation, and angular deviation. Data were stratified by operator experience, jaw location, and implant position. No significant differences were found between expert and non-expert operators in head deviation (1.26 ± 0.51 mm vs. 1.54 ± 0.63 mm, p = 0.29), tip deviation (1.70 ± 0.50 mm vs. 1.81 ± 0.53 mm, p = 0.64), angular deviation (3.83 ± 1.90° vs. 3.32 ± 1.69°, p = 0.54), or surgical time (3.60 ± 1.45 min vs. 4.31 ± 2.67 min, p = 0.84). Anterior implants showed significantly greater head (1.69 ± 0.57 mm vs. 1.13 ± 0.46 mm, p = 0.03) and tip deviations (1.99 ± 0.41 mm vs. 1.54 ± 0.50 mm, p = 0.04) compared to posterior implants. Mandibular implants required longer surgical time than maxillary implants (4.90 ± 2.37 min vs. 2.87 ± 1.01 min, p = 0.03). Within the limitations of this cadaver study, s-CAIS demonstrated predictable accuracy for immediate implant placement in post-extraction sockets, with operator experience not significantly influencing placement precision or surgical time. Static guided surgery may standardize outcomes and support surgical training in implant dentistry. The use of s-CAIS in a cadaver model demonstrated predictable accuracy for immediate implant placement in post-extraction sockets irrespective of operator experience. Its use might be considered for clinical training sessions.