Implant treatment is a growing field in dentistry, and many clinicians aim to increase their scope of practice by including such treatment. One of the main challenges encountered by clinicians new to implant dentistry is the determination and controlling of implant location. It is the consensus that implant placement must be planned to achieve an acceptable position for an ideal restorative outcome [1, 2]. Poorly placed implants were demonstrated to be associated with increased marginal bone loss, and may lead to the violation of nearby vital anatomic structures [1,2,3]. Restoration of poorly placed implants may not have an optimal morphology and emergence profile, which can affect esthetics and impede plaque control. In addition, restoring poorly placed implants is technically far more challenging with increased time and cost [1,2,3].

While the conventional approach combines the planned restorative outcome with the 3D radiographic information via a radiographic guide, transferring this information to execute the osteotomy at the planned position and angulation is challenging. To overcome this problem, surgical guides were advocated to control implant location, angulation, drilling, and subsequent positioning [4, 5]. Today, with the advancement of digital technologies [6], static computer-assisted implant placement (sCAIP) protocols were proposed as alternatives [7,8,9]. They involve using commercial software programs to decide on the ideal implant position, digitally designing the surgical guide, and producing the surgical guide by means of 3D printing or milling [10]. Further, manufacturing companies provide surgical guides with prefabricated metal sleeves and drilling handles that correspond to the implant surgical tools, which facilitate exacting implant placement. In addition, it has been proposed that implant placement according to sCAIP protocols are easier, simpler, and more predictable than conventional implant placements [11,12,13]. Some studies showed that the accuracy of sCAIP implants is less influenced by the lack of experience of the operator [12,13,14].

Currently, there are two protocols for sCAIP: fully guided (FG) and pilot-guided (PG) protocols [15, 16]. The FG protocol is related to implant manufacturers and has the advantage of controlling all the drilling, tapping, and implant placement through the surgical guide. The PG protocol is an abbreviated form of guided surgery, and only guides the pilot drill. The rest of the surgical procedure is completed freehand. Frequently, the PG protocol is related to open source software programs that allow guide production by 3rd party 3D printers. As a result, the PG protocol is generally more economical than the FG protocol. However, the PG protocol cannot control all the steps of implant placement.