Accuracy of half-guided implant placement with machine-driven or manual insertion: a prospective, randomized clinical study

OBJECTIVES: To compare the accuracy of implant placement performed with either a surgical motor or a torque wrench as part of a half-guided surgical protocol. MATERIALS AND METHODS: Implant insertion with half-guided surgical protocol was utilized by surgical motor (machine-driven group) or torque wrench (manual group) in the posterior maxilla. After the healing period, accuracy comparison between planned and actual implant positions was performed based on preoperative cone beam computed tomography and postoperative digital intraoral scans. Coronal, apical, and angular deviations, insertion time, and insertion torque were evaluated. RESULTS: Forty patients were treated with 1 implant each; 20 implants were inserted with a surgical motor and 20 implants with a torque wrench. Global coronal and apical deviations were 1.20 ± 0.46 mm and 1.45 ± 0.79 mm in the machine-driven group, and 1.13 ± 0.38 mm and 1.18 ± 0.28 mm in the manual group (respectively). The mean angular deviation was 4.82 ± 2.07° in the machine-driven group and 4.11 ± 1.63° in the manual group. Mean insertion torque was 21.75 ± 9.75 Ncm in the machine-driven group, compared to 18.75 ± 7.05 Ncm in the manual group. Implant placement duration was 9.25 ± 1.86 s in the machine-driven group at a speed of 50 rpm, and 36.40 ± 8.15 s in the manual group. CONCLUSION: No significant difference was found between the two groups in terms of accuracy and mean insertion torque, while machine-driven implant placement was significantly less time-consuming. CLINICAL RELEVANCE: Optimal implant placement accuracy utilized by half-guided surgical protocol can be achieved with both machine-driven and torque wrench insertion. TRIAL REGISTRATION: ID: NCT04854239.