Purpose This study aimed to investigate the performance of novice versus experienced practitioners for placing dental implant using freehand, static guided and dynamic navigation approaches. Methods A total of 72 implants were placed in 36 simulation models. Three experienced and three novice practitioners were recruited for performing the osteotomy and implant insertion with freehand, surgical guide (pilot-drill guidance) and navigation (X-Guide, X-Nav technologies) approaches. Each practitioner inserted 4 implants per approach randomly with a 1-week gap to avoid memory bias (4 insertion sites × 3 approaches × 6 practitioners = 72 implants). The performance of practitioners was assessed by comparing actual implant deviation to the planned position, time required for implant placement and questionnaire-based self-confidence evaluation of practitioners on a scale of 1–30. Results The navigation approach significantly improved angular deviation compared with freehand (P < 0.001) and surgical guide (P < 0.001) irrespective of the experience. Surgical time with navigation was significantly longer compared to the freehand approach (P < 0.001), where experienced practitioners performed significantly faster compared to novice practitioners (P < 0.001). Overall, self-confidence was higher in favor of novice practitioners with both guided approaches. In addition, the confidence of novice practitioners (median score = 26) was comparable to that of experienced practitioners (median score = 27) for placing implants with the navigation approach. Conclusions Dynamic navigation system could act as a viable tool for dental implant placement. Unlike freehand and static-guided approaches, novice practitioners showed comparable accuracy and self-confidence to that of experienced practitioners with the navigation approach. Graphical Abstract

Sinus floor elevation (SFE) is a standard surgical technique used to compensate for alveolar bone resorption in the posterior maxilla. Such a surgical procedure requires radiographic imaging pre- and postoperatively for diagnosis, treatment planning, and outcome assessment. Cone beam computed tomography (CBCT) has become a well-established imaging modality in the dentomaxillofacial region. The following narrative review is aimed to provide clinicians with an overview of the role of three-dimensional (3D) CBCT imaging for diagnostics, treatment planning, and postoperative monitoring of SFE procedures. CBCT imaging prior to SFE provides surgeons with a more detailed view of the surgical site, allows for the detection of potential pathologies three-dimensionally, and helps to virtually plan the procedure more precisely while reducing patient morbidity. In addition, it serves as a useful follow-up tool for assessing sinus and bone graft changes. Meanwhile, using CBCT imaging has to be standardized and justified based on the recognized diagnostic imaging guidelines, taking into account both the technical and clinical considerations. Future studies are recommended to incorporate artificial intelligence-based solutions for automating and standardizing the diagnostic and decision-making process in the context of SFE procedures to further improve the standards of patient care.

Lack of evidence exists related to the investigation of the accuracy and efficacy of novice versus experienced practitioners for dental implant placement. Hence, the following in vitro study was conducted to assess the accuracy of implant positioning and self-efficacy of novice compared to experienced surgeons for placing implant using freehand (FH), pilot drill-based partial guidance (PPG) and dynamic navigation (DN) approaches. The findings revealed that DN significantly improved the angular accuracy of implant placement compared with FH (P < 0.001) and PPG approaches (P < 0.001). The time required with DN was significantly longer than FH and PPG (P < 0.001), however, it was similar for both novice and experienced practitioners. The surgeon’s self-confidence questionnaire suggested that novice practitioners scored higher with both guided approaches, whereas experienced practitioners achieved higher scoring with PPG and FH compared to DN. In conclusion, implant placement executed under the guidance of DN showed high accuracy irrespective of the practitioner’s experience. The application of DN could be regarded as a beneficial tool for novices who offered high confidence of using the navigation system with the same level of accuracy and surgical time as that of experienced practitioners.