Dynamic Navigation vs Freehand Dental Implant Placement: A Systematic Review of Surgical Efficiency and Clinical Outcomes

Muhammad Rizqan; Muhammad Rizqi Maulana Fatah

doi:10.60084/ijcr.v4i1.395

Authors

Muhammad Rizqan Faculty of Dentistry, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
Muhammad Rizqi Maulana Fatah General Dentist, Taksim Hospital, Cibarusah, Bekasi, Indonesia

DOI:

https://doi.org/10.60084/ijcr.v4i1.395

Keywords:

Dynamic navigation, Dental implant placement, Freehand technique, Surgical accuracy, Implant complications

Abstract

Precise implant positioning is critical for functional, biological, and prosthetic success in dental implant therapy. Dynamic navigation systems provide real-time intraoperative guidance and may enhance placement accuracy compared with conventional freehand techniques. However, their impact on clinical outcomes remains incompletely clarified. To evaluate clinical outcomes, surgical efficiency, and complication rates of dynamic navigation–assisted dental implant placement compared with freehand techniques in adult patients. A systematic search of PubMed, Cochrane Library, and ScienceDirect identified comparative clinical studies evaluating dynamic navigation versus freehand implant placement. Primary outcomes included postoperative pain, operative time, surgical complications, and early implant success. Nine studies were included in the qualitative synthesis. Dynamic navigation consistently demonstrated significantly reduced coronal, apical, and angular deviations compared with freehand placement. Selected studies reported shorter operative times and lower early postoperative pain in navigation groups. Major complications were rare in both techniques, although minor transient neurosensory disturbances were reported more frequently with freehand placement. Early implant survival rates were high and comparable across groups. While dynamic navigation reliably enhances surgical precision and may improve procedural efficiency, its influence on early implant survival appears limited. Improved accuracy may offer greater safety in anatomically complex regions; however, long-term clinical superiority remains uncertain. Dynamic navigation improves implant placement accuracy and may enhance surgical efficiency without increasing complications, but further long-term evidence is needed to establish definitive clinical advantages.

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References

Moraschini, V., Poubel, L. A. da C., Ferreira, V. F., and Barboza, E. dos S. P. (2015). Evaluation of Survival and Success Rates of Dental Implants Reported in Longitudinal Studies with a Follow-up Period of at Least 10 Years: A Systematic Review, International Journal of Oral and Maxillofacial Surgery, Vol. 44, No. 3, 377–388. doi:10.1016/j.ijom.2014.10.023.
Zhou, W., Liu, Z., Song, L., Kuo, C., and Shafer, D. M. (2018). Clinical Factors Affecting the Accuracy of Guided Implant Surgery—A Systematic Review and Meta-Analysis, Journal of Evidence Based Dental Practice, Vol. 18, No. 1, 28–40. doi:10.1016/j.jebdp.2017.07.007.
Vercruyssen, M., Cox, C., Coucke, W., Naert, I., Jacobs, R., and Quirynen, M. (2014). A Randomized Clinical Trial Comparing Guided Implant Surgery (Bone‐ or Mucosa‐supported) with Mental Navigation or the Use of a Pilot‐drill Template, Journal of Clinical Periodontology, Vol. 41, No. 7, 717–723. doi:10.1111/jcpe.12231.
D’haese, J., Ackhurst, J., Wismeijer, D., De Bruyn, H., and Tahmaseb, A. (2017). Current State of the Art of Computer‐guided Implant Surgery, Periodontology 2000, Vol. 73, No. 1, 121–133. doi:10.1111/prd.12175.
Derks, J., and Tomasi, C. (2015). Peri‐implant Health and Disease. A Systematic Review of Current Epidemiology, Journal of Clinical Periodontology, Vol. 42, No. S16, S158–S171. doi:10.1111/jcpe.12334.
Shiba, T., Komatsu, K., Takeuchi, Y., Koyanagi, T., Taniguchi, Y., Takagi, T., Maekawa, S., Nagai, T., Kobayashi, R., Matsumura, S., Katagiri, S., Izumi, Y., Aoki, A., and Iwata, T. (2024). Novel Flowchart Guiding the Non-Surgical and Surgical Management of Peri-Implant Complications: A Narrative Review, Bioengineering, Vol. 11, No. 2, 118. doi:10.3390/bioengineering11020118.
Vercruyssen, M., Laleman, I., Jacobs, R., and Quirynen, M. (2015). Computer‐supported Implant Planning and Guided Surgery: A Narrative Review, Clinical Oral Implants Research, Vol. 26, No. S11, 69–76. doi:10.1111/clr.12638.
Tahmaseb, A., Wismeijer, D., Coucke, W., and Derksen, W. (2014). Computer Technology Applications in Surgical Implant Dentistry: A Systematic Review, The International Journal of Oral & Maxillofacial Implants, Vol. 29, No. Supplement, 25–42. doi:10.11607/jomi.2014suppl.g1.2.
Khaohoen, A., Powcharoen, W., Yoda, N., Rungsiyakull, C., and Rungsiyakull, P. (2025). Accuracy in Dental Implant Placement: A Systematic Review and Meta-Analysis Comparing Computer-Assisted (Static, Dynamic, Robotics) and Noncomputer-Assisted (Freehand, Conventional Guide) Approaches, The Journal of Prosthetic Dentistry, Vol. 134, No. 1, 91.e1-91.e25. doi:10.1016/j.prosdent.2025.03.038.
Joda, T., Ferrari, M., Gallucci, G. O., Wittneben, J., and Brägger, U. (2017). Digital Technology in Fixed Implant Prosthodontics, Periodontology 2000, Vol. 73, No. 1, 178–192. doi:10.1111/prd.12164.
Tahmaseb, A., De Clerck, R., and Wismeijer, D. (2009). Computer-Guided Implant Placement: 3D Planning Software, Fixed Intraoral Reference Points, and CAD/CAM Technology. A Case Report, International Journal of Oral and Maxillofacial Implants, Vol. 24, No. 3, 541–546.
Lin, G., Chan, H., and Wang, H. (2014). Effects of Currently Available Surgical and Restorative Interventions on Reducing Midfacial Mucosal Recession of Immediately Placed Single‐Tooth Implants: A Systematic Review, Journal of Periodontology, Vol. 85, No. 1, 92–102. doi:10.1902/jop.2013.130064.
Schneider, D., Marquardt, P., Zwahlen, M., and Jung, R. E. (2009). A Systematic Review on the Accuracy and the Clinical Outcome of Computer‐guided Template‐based Implant Dentistry, Clinical Oral Implants Research, Vol. 20, No. s4, 73–86. doi:10.1111/j.1600-0501.2009.01788.x.
Block, M. S., and Emery, R. W. (2016). Static or Dynamic Navigation for Implant Placement—Choosing the Method of Guidance, Journal of Oral and Maxillofacial Surgery, Vol. 74, No. 2, 269–277. doi:10.1016/j.joms.2015.09.022.
Widmann, G., and Bale, R. J. (2006). Accuracy in Computer-Aided Implant Surgery--a Review, International Journal of Oral and Maxillofacial Implants, Vol. 21, No. 2, 305–313.
Solow, R. A. (2015). Clinical Considerations for Selecting Implant Abutments for Fixed Prosthodontics, General Dentistry, Vol. 63, No. 1, 30–36.
Aydemir, C. A., and Arısan, V. (2020). Accuracy of Dental Implant Placement via Dynamic Navigation or the Freehand Method: A Split‐mouth Randomized Controlled Clinical Trial, Clinical Oral Implants Research, Vol. 31, No. 3, 255–263. doi:10.1111/clr.13563.
Nirula, P. (2023). Feedback on Dental Implants with Dynamic Navigation versus Freehand, Bioinformation, Vol. 19, No. 3, 290–294. doi:10.6026/97320630019290.
Ma, L., Ye, M., Wu, M., Chen, X., and Shen, S. (2023). A Retrospective Study of Dynamic Navigation System-Assisted Implant Placement, BMC Oral Health, Vol. 23, No. 1, 759. doi:10.1186/s12903-023-03481-2.
Younis, H., Lv, C., Xu, B., Zhou, H., Du, L., Liao, L., Zhao, N., Long, W., Elayah, S. A., Chang, X., and He, L. (2024). Accuracy of Dynamic Navigation Compared to Static Surgical Guides and the Freehand Approach in Implant Placement: A Prospective Clinical Study, Head & Face Medicine, Vol. 20, No. 1, 30. doi:10.1186/s13005-024-00433-1.
Deng, H., Geng, N., Yang, S., Dou, X., Wang, H., Chen, S., and Huang, L. (2025). Clinical Study of Dynamic Navigation-Assisted Immediate Implant Placement in Posterior Maxillary Alveolar Bone Defects, BMC Oral Health, Vol. 25, No. 1, 617. doi:10.1186/s12903-025-05976-6.
Zhang, C., AL-Awadhi, Z. A., Geng, N., Mo, S., and Chen, S. (2025). Dynamic Navigation-Assisted Flapless Implant Placement in the Posterior Mandible: A Retrospective and Comparative Study, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Vol. 139, No. 6, 670–683. doi:10.1016/j.oooo.2024.12.018.
Stefanelli, L. V., Mandelaris, G. A., Franchina, A., Pranno, N., Pagliarulo, M., Cera, F., Maltese, F., De Angelis, F., and Di Carlo, S. (2020). Accuracy of Dynamic Navigation System Workflow for Implant Supported Full Arch Prosthesis: A Case Series, International Journal of Environmental Research and Public Health, Vol. 17, No. 14, 5038. doi:10.3390/ijerph17145038.
Jorba‐García, A., Bara‐Casaus, J. J., Camps‐Font, O., Sánchez‐Garcés, M. Á., Figueiredo, R., and Valmaseda‐Castellón, E. (2023). Accuracy of Dental Implant Placement with or without the Use of a Dynamic Navigation Assisted System: A Randomized Clinical Trial, Clinical Oral Implants Research, Vol. 34, No. 5, 438–449. doi:10.1111/clr.14050.
Edelmann, C., Wetzel, M., Knipper, A., Luthardt, R. G., and Schnutenhaus, S. (2021). Accuracy of Computer-Assisted Dynamic Navigation in Implant Placement with a Fully Digital Approach: A Prospective Clinical Trial, Journal of Clinical Medicine, Vol. 10, No. 9, 1808. doi:10.3390/jcm10091808.
Pinter, G. T., Decker, R., Szenasi, G., Barabas, P., and Huszar, T. (2022). Dynamic Navigation for Dental Implant Placement, Journal of Visualized Experiments, No. 187. doi:10.3791/63400.
Pellegrino, G., Ferri, A., Del Fabbro, M., Prati, C., Gandolfi, M., and Marchetti, C. (2021). Dynamic Navigation in Implant Dentistry: A Systematic Review and Meta-Analysis, The International Journal of Oral & Maxillofacial Implants, Vol. 36, No. 5, e121–e140. doi:10.11607/jomi.8770.
Fortin, T., Isidori, M., and Bouchet, H. (2009). Placement of Posterior Maxillary Implants in Partially Edentulous Patients with Severe Bone Deficiency Using CAD/CAM Guidance to Avoid Sinus Grafting: A Clinical Report of Procedure, International Journal of Oral and Maxillofacial Implants, Vol. 24, No. 1, 96–102.
Block, M., Emery, R., Lank, K., and Ryan, J. (2017). Implant Placement Accuracy Using Dynamic Navigation, The International Journal of Oral & Maxillofacial Implants, Vol. 32, No. 1, 92–99. doi:10.11607/jomi.5004.
Esposito, M., Grusovin, M. G., Felice, P., Karatzopoulos, G., Worthington, H. V, and Coulthard, P. (2009). The Efficacy of Horizontal and Vertical Bone Augmentation Procedures for Dental Implants - a Cochrane Systematic Review, European Journal of Oral Implantology, Vol. 2, No. 3, 167–184.
Ma, S., and Fenton, A. (2015). Screw- Versus Cement-Retained Implant Prostheses: A Systematic Review of Prosthodontic Maintenance and Complications, International Journal of Prosthodontics, Vol. 28, No. 2, 127–145. doi:10.11607/ijp.3947.
Albrektsson, T., Dahlin, C., Jemt, T., Sennerby, L., Turri, A., and Wennerberg, A. (2014). Is Marginal Bone Loss around Oral Implants the Result of a Provoked Foreign Body Reaction?, Clinical Implant Dentistry and Related Research, Vol. 16, No. 2, 155–165. doi:10.1111/cid.12142.
Widmann, G., Stoffner, R., and Bale, R. (2009). Errors and Error Management in Image-Guided Craniomaxillofacial Surgery, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology, Vol. 107, No. 5, 701–715. doi:10.1016/j.tripleo.2009.02.011.
Chen, Y., and Su, B. (2022). Accuracy of Computer-Guided Oral Implant Placement and Influencing Factors, Sheng Wu Yi Xue Gong Cheng Xue Za Zhi, Vol. 39, No. 4, 841–847. doi:10.7507/1001-5515.202110070.
Xu, Z., Zhou, L., Zheng, M., Lin, Y., Huang, W., Chen, J., Li, Y., and Wu, D. (2023). The Effect of Implant Surgery Experience on the Learning Curve of a Dynamic Navigation System: An in Vitro Study, BMC Oral Health, Vol. 23, No. 1, 89. doi:10.1186/s12903-023-02792-8.
Papaspyridakos, P., Chen, C.-J., Singh, M., Weber, H.-P., and Gallucci, G. O. (2012). Success Criteria in Implant Dentistry, Journal of Dental Research, Vol. 91, No. 3, 242–248. doi:10.1177/0022034511431252.