Placement of dental implants via the freehand approach may result in damage to the surrounding critical anatomy of undiscordant prosthetic position. A real-time navigational stereotaxic surgical instrument (navigation) may help to alleviate these undesired outcomes in the freehand approach.

All patients received implants in the right and left the side of their upper jaws via the random use of the navigation or the freehand approach. Positional deviations between the planned and placed implants were measured on a final tomographic image matched to the baseline.

Inclusion Criteria:

• men and women aged >18 years.
• Patients approving to participate in the trial and giving written consent
• must be able to open his/her mouth

Exclusion Criteria:

• Hemodynamically significant mitral valve stenosis
• Prosthetic heart valve (annuloplasty with or without prosthetic ring, commissurotomy and/or valvuloplasty are permitted)
• Planned cardioversion (electrical or pharmacological)
• Transient atrial fibrillation caused by a reversible disorder (e.g., thyrotoxicosis, pulmonary embolism, recent surgery, myocardial infacrtion)
• Known presence of atrial myxoma or left ventricular thrombus
• Active endocarditis

Investigation of the post-op images included anonymized patient names providing unbiased analysis.