Comparing Medium to Long‐Term Esthetic, Clinical, and Patient‐Reported Outcomes Between Freehand and Computer‐Assisted Dental Implant Placement: A Cross‐Sectional Study

objective: the aim of the study was to compare medium to long-term clinical and patient-reported outcomes between implants placed with computer-assisted implant surgery (CAIS) and freehand protocols. materials and methods: thirty dental implants in the anterior maxillary region with an average of 4 years after loading were assessed by means of pink esthetic scores (PESs), marginal bone level (MBL), and clinical and patient-reported outcomes. results: CAIS significantly outperformed freehand placement with regard to PES scores (p = 0.011). likewise, implants placed with CAIS showed significantly higher MBLs (p < 0.001). bleeding on probing, probing depth, and prevalence of mucositis did not differ between the groups, while no peri-implantitis was diagnosed. conclusions: the use of CAIS leads to superior outcomes in terms of esthetics and MBLs for implants placed in the esthetic zone as observed in medium to long-term follow-up. no difference was however observed with regard to peri-implant mucosa inflammation. clinical significance: this article highlights the outcome of computer-assisted implant surgery in achieving higher esthetic, MBL, and esthetic satisfaction compared to freehand implant placement. thai clinical trial registry: TCTR20240422015.