Outcome measures of each technique.

BackgroundPartial edentulism poses challenges to oral function, aesthetics, and quality of life. Implant placement techniques—freehand, pilot-drilled, and fully guided—differ in accuracy, surgical time, and outcomes. In this study, only one predefined index implant per patient was analyzed to avoid confounding from multi-implant cases, and template fabrication for the pilot-drilled group was performed using diagnostic wax-up and thermoplastic material. This study evaluated these techniques in partially edentulous patients.MethodsNinety patients were randomly assigned to three groups: freehand (n = 30), pilot- drilled (n = 30), and fully guided (n = 30). Surgery duration, implant placement accuracy, post- operative complications, early implant failure rates, and patient satisfaction were measured. Accuracy was assessed using standardized CBCT imaging at 12 months, and satisfaction was evaluated via a validated questionnaire six months after prosthetic loading.ResultsThe fully guided technique demonstrated superior accuracy (p ConclusionFully guided implant surgery outperformed other techniques in accuracy, efficiency, and patient satisfaction. These findings support fully guided, prosthetically driven workflows as a preferred option for partially edentulous patients, particularly in cases requiring high precision.