Static Computer-assisted Implant Surgery (sCAIS) in Partial Edentulism: Tooth-supported Guides
TL;DR
While Static computer-assisted implant surgery facilitates prosthetically driven implant positioning and minimally invasive approaches, it requires clinical expertise, careful workflow execution, and appropriate patient selection to achieve predictable outcomes.
Abstract
Static computer-assisted implant surgery (sCAIS) has gained widespread adoption in implant dentistry, supported by advances in CBCT imaging, intraoral scanning and digital planning software. Despite growing clinical use, a critical and structured overview of its indications, workflows, and limitations remains relevant for everyday practice. This article provides a comprehensive overview of sCAIS, with particular emphasis on fully guided, tooth-supported approaches in partially edentulous patients. Clinical workflows, accuracy, key determinants of treatment success, indications and limitations are discussed and illustrated by selected clinical cases. A narrative review of the current literature was performed, supplemented by three representative clinical author cases demonstrating the application of sCAIS in anatomically and prosthetically demanding scenarios, including posterior maxillary rehabilitation with short implants, multi-implant placement in a complex partially edentulous maxilla, and implants in the esthetic zone. Static computer-assisted implant surgery consistently demonstrates superior placement accuracy compared with freehand techniques, with mean deviations of 1-1.5 mm and 3-4° of angulation. However, improved accuracy does not translate into measurable differences in implant survival, osseointegration, or patient-reported outcomes. Primary stability is primarily determined by bone quality and implant design rather than guide use. Tooth-supported guides offer the highest positional stability. Cumulative errors throughout the digital workflow and anatomical constraints – such as restricted mouth opening – remain relevant limitations. The use of sCAIS should be based on a clear clinical indication and evaluated on a case-by-case basis. While it facilitates prosthetically driven implant positioning and minimally invasive approaches, it requires clinical expertise, careful workflow execution, and appropriate patient selection to achieve predictable outcomes.