Accuracy of Photogrammetry in Full-Arch Implant Rehabilitation: A Systematic Review

Introduction: Precise transfer of implant positions is critical for the success of full-arch rehabilitations. Photogrammetry-based workflows aim to mitigate the cumulative stitching errors common in intraoral scanning (IOS), though performance varies across different systems and protocols. To evaluate the accuracy (trueness and precision) of photogrammetry for edentulous complete-arch implant capture compared to IOS and conventional impressions. Materials and Methods: PubMed, Web of Science, Scopus, and Embase were searched for publications from 2010 through 2025; the final search was run on January 15, 2026. Forty-eight studies (11 clinical/in vivo and 37 in vitro) assessing photogrammetry in full-arch scenarios (≥4 implants) were included. Primary outcomes were linear, angular, and 3D deviations. Risk of bias was assessed with QUADAS-2 or setting-specific modifications, and certainty was assessed by outcome domain using GRADE. Owing to methodological heterogeneity, a qualitative synthesis and risk-of-bias-stratified robustness analysis were performed. Results: Forty-eight studies were included. Overall risk of bias was low in 3 studies (6.3%), raised some concerns in 37 (77.1%), and was high in 8 (16.7%). The seven formal GRADE outcome domains were rated moderate (n = 1), low (n = 3), or very low certainty (n = 3). The only moderate-certainty domain—clinical precision of photogrammetry versus IOS—was based on correlated endpoints from one 19-participant cross-over study, which reported lower mean 3D spatial-fit deviation with photogrammetry (7 ± 5 μm) than IOS (61 ± 54 μm). Laboratory trueness and precision findings were mixed and protocol-dependent. Conclusion: Photogrammetry may provide a precision advantage in selected complete-arch workflows, but the evidence does not establish consistent clinical superiority over IOS or conventional impressions. Confidence is limited by the predominance of studies with methodological concerns, indirect laboratory evidence, protocol heterogeneity, and reliance on single studies for several outcome claims. Device- and protocol-specific verification remains necessary pending independent clinical comparisons linked to prosthesis-level outcomes.