Dynamic Navigation-Guided Mini-Implant Placement in the Infrazygomatic Crest: Accuracy, Efficiency, and Clinical Integration—A Randomized Controlled Trial

Aim: To evaluate and compare the accuracy, time efficiency, and success rates of placing mini-implants in the infrazygomatic crest (IZC) region, using a dynamic navigation (DN) system, versus the conventional freehand method. Materials and Methods: This split-mouth, randomized controlled trial included 15 subjects requiring bilateral IZC mini-implants. A total of 30 sites were randomly allocated to either Group A (intervention), where placement was guided by a DN system, or Group B (control), where placement was performed freehand (FH). Post-placement cone-beam computed tomography (CBCT) scans were used to measure deviations at the entry point, apex, and in the angle of placement. Success rates and total time for placement were also recorded and compared. Statistical analysis was performed using independent t tests and Kendall’s Tau correlation test. Results: The DN group demonstrated significantly higher accuracy, with lower deviations at the entry point ( P = 0.001) and in the placement angle ( P < 0.001) compared to the FH group. There were no significant intergroup differences in apical deviations ( P > 0.05). However, the FH method had a higher success rate (86.6%) than the DN method (80.0%), although this difference was not statistically significant ( P = 0.201). The time required for placement was significantly longer for the DN group (41.56 ± 6.76 min) compared to the FH group (15.88 ± 1.52 min) ( P < 0.001). Conclusion: DN significantly improves the accuracy of mini-implant placement in the challenging IZC region. However, this increased accuracy comes at the cost of a substantially longer clinical procedure and does not translate to a higher success rate compared to the freehand method.