STATIC VERSUS DYNAMIC NAVIGATION PREDICTABILITY AND THE EMERGENCE OF SMART, BIOSENSOR-INTEGRATED IMPLANTS IN MODERN IMPLANT DENTISTRY: A NARRATIVE REVIEW

Digital technologies have transformed implant dentistry over the past two decades, with static computer-assisted implant surgery (sCAIS) and dynamic computer-assisted implant surgery (dCAIS) now established as predictable means of transferring a virtual implant plan to the surgical field. This narrative review synthesises current evidence on the comparative predictability of sCAIS and dCAIS, with particular attention to unresolved questions of cost-effectiveness, learning-curve burden, and performance in immediate post-extraction and severely atrophic sites, before examining the parallel but far less mature field of smart, biosensor-functionalised implants. A structured search of PubMed, ScienceDirect and related databases identified systematic reviews, meta-analyses, randomised and retrospective clinical studies, and narrative reviews published predominantly within the last decade. Both sCAIS and dCAIS achieve clinically acceptable accuracy, with meta-analytic entry-point deviations in the region of 1.0-1.4 mm and angular deviations of approximately 3-4 degrees, and neither modality shows consistent, clinically decisive superiority over the other. Dynamic navigation appears to preserve this accuracy in immediate extraction sockets and in severely resorbed ridges, including transcrestal sinus procedures, although this evidence base remains comparatively small. Cost, equipment footprint, and a steep operator learning curve continue to constrain the routine adoption of both workflows, and robust economic analyses are lacking. Sensor-functionalised implants capable of monitoring micromotion, pH, and peri-implant inflammation remain overwhelmingly confined to bench-top and early translational studies, held back by miniaturisation, powering, biofouling, and an immature regulatory pathway. Both fields require standardised outcome reporting, prospective economic evaluation, and, for smart implants, dedicated regulatory frameworks before they can be considered routine clinical tools.