{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T19:01:25Z","timestamp":1792522885890,"version":"4.5.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The present study evaluated the transfer accuracy of computer-aided designed and manufactured (CAD\/CAM) milled guides compared with freehand placement of orthodontic temporary anchorage devices (TADs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sixty TADs were placed in 30 typodonts, using either CAD\/CAM-milled guides or conventional freehand insertion. The freehand insertions were performed by one orthodontist and one oral surgeon. Micro-CT scans were obtained to determine actual TAD positions. Deviations from planned positions were assessed via vector analysis in vertical, horizontal, and transversal axes, as well as angular displacement. Linear mixed models with Items as random effects were applied to evaluate the influence of group and quadrant as fixed effects while accounting for repeated measures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Guided placement demonstrated significantly higher accuracy across almost all linear and angular dimensions compared with freehand insertion (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). Greater accuracy was shown for the oral surgeon compared with the orthodontist for freehand placement (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.01). Inter- and intra-observer agreement was excellent.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>CAD\/CAM milled guides significantly improved TAD placement accuracy compared with freehand insertion. This preclinical study supports their potential clinical benefit in single-session guided workflows, particularly for enhancing precision across different operator experience levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1834583","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T04:36:18Z","timestamp":1781757378000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Milled surgical guides vs. freehand placement of orthodontic implants: a preclinical micro-CT study"],"prefix":"10.3389","volume":"7","author":[{"given":"Alexander","family":"Schw\u00e4rzler","sequence":"first","affiliation":[{"name":"Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danijel","family":"Domic","sequence":"additional","affiliation":[{"name":"Clinical Division of Oral Surgery, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]},{"name":"Etiology and Therapy of Periodontal and Periimplant Diseases (ETEP) Research Group, Faculty of Dentistry, Complutense University of Madrid","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophia","family":"Panwinkler","sequence":"additional","affiliation":[{"name":"Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Chitan","sequence":"additional","affiliation":[{"name":"Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benedikt","family":"Sagl","sequence":"additional","affiliation":[{"name":"Competence Center Artificial Intelligence in Dentistry, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erwin","family":"Jonke","sequence":"additional","affiliation":[{"name":"Clinical Division of Orthodontics, University Clinic of Dentistry, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1111\/ocr.12451","article-title":"Palatal temporary skeletal anchorage devices (TSADs): what to know and how to do?","volume":"24","author":"Ahn","year":"2021","journal-title":"Orthod Craniofac Res"},{"key":"B2","first-page":"728","article-title":"The easy driver for placement of palatal mini-implants and a maxillary expander in a single appointment","volume":"51","author":"De Gabriele","year":"2017","journal-title":"J Clin Orthod"},{"key":"B3","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.ajodo.2018.12.017","article-title":"CAD-CAM-fabricated mini-implant insertion guides for the delivery of a distalization appliance in a single appointment","volume":"156","author":"Wilmes","year":"2019","journal-title":"Am J Orthod Dentofacial Orthop"},{"key":"B4","first-page":"239","article-title":"Boneborne rapid palatal expansion-the virtual way","volume":"55","author":"Ludwig","year":"2022","journal-title":"J Clin Orthod"},{"key":"B5","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1186\/s12903-020-01292-3","article-title":"CBCT and CAD-CAM technology to design a minimally invasive maxillary expander","volume":"20","author":"S\u00e1nchez-Riofr\u00edo","year":"2020","journal-title":"BMC Oral Health"},{"key":"B6","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1055\/a-2344-3920","article-title":"Borderline Klasse III Therapie mit skelettal verankerter CAD\/CAM Apparatur","volume":"57","author":"Schw\u00e4rzler","year":"2025","journal-title":"Inf Orthod Kieferorthop"},{"key":"B7","doi-asserted-by":"publisher","first-page":"e70148","DOI":"10.1002\/cre2.70148","article-title":"Glossary of computer-assisted implant surgery and related terms. 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