Guided Implant Surgery: Evolution, Accuracy, and Clinical Relevance

The advent of surgical guides has revolutionized implantology by enhancing the precision, safety, and predictability of implant placement. Surgical guides act as a crucial link between digital planning and clinical execution, translating virtual implant positioning into an accurate intraoral reality. With advancements in cone-beam computed tomography (CBCT) and computer-aided design/computer-aided manufacturing (CAD/CAM) technologies, various types of guides—conventional, partially guided, and fully guided—have been developed to cater to different clinical needs. These guides assist in achieving optimal three-dimensional implant positioning, ensuring ideal prosthetic outcomes, and minimizing intraoperative complications. Moreover, the integration of 3D printing and digital workflows has significantly reduced fabrication time and improved customization. Despite their numerous advantages, limitations such as technique sensitivity, cost, and potential deviations during clinical transfer still exist. Continuous innovations in digital design software, navigation systems, and material science are expected to further refine the accuracy and clinical applicability of surgical guides. This article reviews the evolution, classification, fabrication techniques, advantages, limitations, and future perspectives of surgical guides in implant dentistry.