This investigation aimed to compare the precision of dental implant placement using two categories of surgical guides: thermoplastic and three-dimensional (3D) printed. A total of 32 implants were inserted in 20 healthy individuals, each presenting a single missing tooth. The implant sites were randomly divided into two groups: Group A (thermoplastic guide, n = 16 implants) and Group B (3D-printed guide, n = 16 implants). All implant placements were digitally planned through a uniform protocol, and discrepancies between the planned and actual implant positions were analyzed using medical imaging software. The evaluated parameters included angular deviation (AD), three-dimensional error at the coronal entry point, three-dimensional error at the apex (3D EA), vertical deviation (VD), and overall composite deviation. Although all outcome measures showed improvement, statistically significant differences were noted for AD (P = 0.005), 3D EA (P = 0.01), and VD (P = 0.007). For Group A, the mean ± SD for AD, 3D EA, and VD were 5.58° ± 1.93°, 0.96 ± 0.32 mm, and 0.58 ± 0.36 mm, respectively. In Group B, these values were 3.94° ± 0.64°, 0.64 ± 0.35 mm, and 0.29 ± 0.13 mm (P < 0.05). Within the limits of this study, implants guided by 3D-printed templates achieved higher placement accuracy and exhibited smaller deviations from their preoperative positions compared to those placed with thermoplastic guides.
