The aim of this systematic review was to assess the scientific literature on the accuracy of guided implant surgery and the methods used for its quantification. Two reviewers searched PubMed and the Cochrane Library to identify relevant articles published before 2023. Two methodological quality-assessment tools were used to assess the quality of the studies included. Inter-investigator reliability was verified using kappa statistics. Twenty-three clinical studies out of the 3299 articles initially identified met the inclusion criteria. The “radiographic matching method” and “digital registration method” were used to assess accuracy in guided surgery. The mean angular, coronal, and apical deviations of mucosa-supported guides ranged from 2.7◦ to 5.14◦, 0.87 mm to 2.05 mm, and 1.08 mm to 2.28 mm, respectively. With bone-supported guides, these ranged from 2.49◦ to 5.08◦, 0.71 mm to 1.60, and 0.77 mm to 1.65 mm, respectively. In tooth-supported guides, deviations were from 2.5◦ to 5.62◦, 0.39 mm to 1.63 mm and 0.28 mm, and 1.84 mm, respectively. Regardless of the evaluation method, all systems exhibit some error. The minimum and maximum deviation ranges found between the planned and placed implants show that, although deviations occur, guided surgery is not far from accurate.
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