Abstract: Objective This study analyzed the accuracy of implant placement in edentulism implant surgeries guided by metal guides through a case series. Methods Five cases of full or partial edentulism implant surgeries with a total of 35 implants were included. Preoperative cone beam computed tomography (CBCT) was performed to obtain three-dimensional data, which was then used to design the implant guide within software. Titanium metal guides were 3D-printed and used for guided implant placement. The accuracy of the metal guides was analyzed by comparing the planned implant positions with the postoperative positions. Results After excluding 5 partially guided implants, 1 zygomatic implant, and 4 maxillary sinus elevation implants, a total of 25 implants were included in the analysis. No guide fractures or thermal osteonecrosis were observed, and all implants achieved successful healing. In the mesiodistal direction, the average apex horizontal displacement was 0.91 (0.28-1.35) mm, neck horizontal displacement was 0.46 (0.23-0.83) mm, apex vertical displacement was 0.57 (0.29-0.80) mm, and angular deviation was 1.93° (1.02°-3.40°). In the buccolingual direction, the average apex horizontal displacement was 0.84 (0.43-1.51) mm, neck horizontal displacement was 0.77 (0.32-1.05) mm, apex vertical displacement was 0.52 (0.30-0.88) mm, and angular deviation was 2.77° (2.09°-4.21°). Conclusion In this limited case series of edentulism implant surgeries, metal guide plates have shown similar accuracy and clinical outcomes to those of resin guide plates.

Key words: Edentulism, Implant, Surgical guide, Digitalization, CAD/CAM