###### Abstract  
Dental implant placement is crucial in oral rehabilitation, requiring precision for successful outcomes. Digital technologies, including surgical guides, enhance predictability and efficiency in implant procedures. However, their impact on implant positioning accuracy is still under investigation. This systematic review aimed to evaluate the literature on implant accuracy using digital prosthetically-derived surgical guides. Registered in PROSPERO (CRD 42023483194), the review employed a PICO strategy and searched PubMed for English-language, in vivo studies from 2013 to 2023 on restrictive digital prosthetically-derived surgical guides. Two reviewers independently assessed records, with a third verifying the decisions. PRISMA guidelines were followed, yielding 24 results after excluding nine duplicates. Ten studies met the criteria after title, abstract, and keyword review, with three included after verification. These studies showed coronal deviations of 0.44 mm to 0.56 mm, apical deviations of 0.64 mm to 1.03 mm, angular deviations of 2.03\({}^{\circ}\) to 2.42\({}^{\circ}\), and vertical deviations of 0.19 mm to 0.45 mm. Superior accuracy was noted with static guided techniques, while bilateral guides offered stability and printed guides were cost-effective. A surgical guide that comes from a planning with a primary wax-up of the prosthesis leads to the placement of a dental implant that can be functionally and esthetically rehabilitated. Further research is needed to standardize outcomes and improve implant protocols and patient outcomes. Keywords:dental implants; flapless implant surgery; template-guided surgery; digital prosthetically-derived surgical guides; accuracy +
Footnote †: journal: Medical(CBCT) and intraoral scanning, has made it possible to virtually plan implant treatments in advance [3]. These tools allow a more accurate analysis of adjacent anatomical structures, facilitate prosthetic-guided surgical procedures, and optimize the materialization of surgical guides with improved accuracy [4; 5; 6]. The prosthetically guided implant protocol involves the virtual planning of a dental implant using 3D planning software (Figure 1). This process requires a wax-up file of the teeth to be replaced, along with a Cone Beam Computed Tomography (CBCT) scan, considering the aesthetic, functional, and anatomical criteria of the prosthesis to achieve correct three-dimensional implant positioning. In contrast to surgical guides not designed from prosthetically guided planning, this approach offers several significant advantages. For instance, it allows for better prediction and control over the final aesthetic outcome by taking into account the position and shape of adjacent teeth and occlusion. Furthermore, integrating prosthesis design into implant planning can help prevent later complications related to aesthetic and functional aspects of the prosthesis. Other advantages of digital prosthetically-derived surgical guides include a shorter surgical time and higher accuracy in placing the implants. In terms of applications, the use of prosthetically guided surgical guides is particularly beneficial in complex cases requiring precise integration with existing dental structures or when optimizing the aesthetic outcome. This can be crucial in complete or partial rehabilitations where precision and predictability are critical for treatment success [7]. Compared to conventional surgical guides that do not incorporate prosthetic planning, the main difference lies in the level of detail and precision achieved. While conventional guides may primarily focus on implant placement relative to bone structures, prosthetically guided guides enable a more comprehensive planning approach that incorporates functional and aesthetic aspects from the outset of the planning process. This can lead to more predictable and satisfactory outcomes for both the professional and the patient. However, any prosthetic-guided implant treatment will depend on the protocol followed and the correct execution by the operator.