الفهرس 
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Abstract
This work aimed to evaluate the accuracy of dental implants placement with flapless surgery using two designs of surgical stents.
The presentstudy was conducted on twelve patients (7 females and 5 males) selected from the Outpatient Clinic of the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Alexandria University. Each had extracted mandibular posterior teeth. Their ages ranged between 20 and 50 years with a mean age of 35 years.
Twenty implants were used in this study. Ten implants were placed using the CAD- CAM surgical stents and ten implants were placed using the conventional surgical stents.
Clinical evaluation was performed immediately then after one weekfor the presence of pain, tenderness, infection and swelling. Delayed follow up was performed at 1, 3 and 6 months to evaluatethe modified gingival index, probing depth and implant mobility.
Six cases exhibitedminimal pain, two cases exhibitedminimal pain and swelling which subsided within few days after surgery. None of them developed neither infection nor mobilitythroughout the study period. All patients showed a modified gingival score of 0.
The mean probing deptharound the implants placed with the CAD-CAM stents had more values than the implants placed with conventional stentson the 3rd months and 6th months during the postoperative follow up period. The difference was not statistically significant
CBCTwas taken immediately post-operatively to evaluate the accuracy of dental implant placement.
The accuracy of implants placement was evaluated by pairing the pre-operative and post-operative CBCT and measuring the values of deviation between the virtually planned and surgically placed implants position.
Computer guided implants were generally placed closer to planned positions. Results were statistically significant for angular difference , coronal distance, and apical difference .
In addition, CAD/CAM guided implants showed more consistency in accuracy, whereas the conventional guides displayed more variability.