Comparative Analysis of Implant Placement Accuracy Using Augmented Reality Technology Versus 3D-Printed Surgical Guides: A Controlled In Vitro Study

Abstract

Purpose: The objective of this study was to evaluate and compare the precision of dental implant placements using augmented reality (AR)-iPhone (Apple, Cupertino, CA, USA) navigation technology versus conventional 3D-printed surgical guides. The accuracy was assessed by comparing the actual implant positions to their predefined three-dimensional (3D) locations in surgical plans using the Exocad software (Exocad, Dormstadt, Germany). Materials and Methods: Fourteen standardized mandibular models were divided into two groups: AR-guided (AR1-AR7) and 3D-printed surgical guide-assisted (Group 1–7). Each model received four implants in positions 35, 32, 42, and 45. Postoperative CBCT scans were aligned with the preoperative plans in the Exocad software to measure three-dimensional deviations, including total entry error, total apex error, and angular error. Statistical analysis was performed using the Statistica 12 software (StatSoft, Tulsa, OK, USA), incorporating Shapiro–Wilk normality tests, ANOVA, and post hoc LSD tests (where applicable). Results: The in vitro comparative experiment demonstrated AR group superior accuracy with mean deviations of 0.42 ± 0.12 mm at the entry point and 0.51 ± 0.18 mm at the apex, compared to 0.48 ± 0.15 mm and 0.58 ± 0.22 mm, respectively, in the 3D-printed guide group (p < 0.05). Angular deviation was significantly lower in the AR group (1.8° ± 0.6°) versus the guide group (2.1° ± 0.7°, p = 0.009). Descriptive statistics revealed the median apex error was 0.49 mm (IQR: 0.38–0.61) for AR versus 0.56 mm (IQR: 0.45–0.72) for guides. Conclusions: AR iPhone navigation technology achieved clinically acceptable accuracy compared to static 3D-printed guides, particularly in controlling angular deviations. While both methods produced clinically acceptable results, AR technology represents a significant advancement for precision-sensitive cases.