Clinical justification of surgical techniques in dental implantation

The paper presents an analytical review of 40 contemporary domestic and foreign scientific publications from 2021 to 2025, focused on the comparative analysis of surgical techniques in dental implantation. The review evaluates implant placement accuracy parameters, survival rates, and clinical efficacy of various protocols, including freehand placement, static computer-aided implant surgery (sCAIS), and dynamic navigation (dCAIS). Based on meta-analyses and clinical trials, a statistically significant superiority of guided methods is demonstrated: fully guided static navigation reduces angular implant deviation to 2.1°–3.5° (compared to 10.04° in the freehand approach) and linear deviation to 0.73–1.2 mm. The accuracy of static navigation is shown to highly depend on the surgical template support type, with tooth-supported templates exhibiting the lowest deviation (0.44 mm). Furthermore, the efficacy of a fully digital workflow is assessed, which achieves an optimal marginal fit of prosthetic restorations within 40–60 µm and reduces the number of clinical appointments to 3–4. The necessity of transitioning to prosthetically-driven treatment planning is justified, as it minimizes the risk of aesthetic and functional complications. The review also systemizes biological risk factors, such as smoking, type 2 diabetes mellitus, and regional variability in bone density, which require individualization of surgical protocols and pharmacological support. Modern methods for removing osseointegrated implants using the counter-torque rotation technique (CTRT) are discussed, along with future trends including the integration of artificial intelligence and finite element analysis (FEA). It is concluded that guided surgery and digital protocols currently represent the standard for safety and predictability in modern implant dentistry.