This study aimed to assess the influence of magnetic resonance imaging (MRI) protocol on the decision-making for the positioning of dental implants in edentulous arches in comparison to planning based on cone beam computed tomography (CBCT). One phantom was scanned with CBCT and two MRI protocols (T1- and T2-weighted). Two calibrated examiners performed digital implant planning (coDiagnostiX, Dental Wings), considering a digital prosthetic planning and alveolar ridge surface scan. Four implants were planned for each patient dataset, and the angular deviation between the long axis of the implants and the prosthetic planning occlusal plane was measured. Each examiner planned 40 implants, 12 implants with CBCT and 28 implants with MRI (16 with T1 and 12 with T2 images). Significant differences in angle deviation were observed between CBCT, T1, and T2 in the anterior region for both examiners (p=0.009 for examiner 1 and p=0.042 for examiner 2). Implants planned with CBCT showed significantly lower angular deviation than those based on the T1 and T2 scans for both examiners (p=0.028 and p=0.046 for examiner 1 and p=0.028 and p=0.027 for examiner 2). No significant difference in angular deviation was found between T1 and T2 for both examiners (examiner 1: p=0.600, examiner 2: p=0.916). Compared to CBCT planning, the MRI protocol influenced decision-making for anterior dental implants, with angular deviations within acceptable clinical thresholds, but further studies are needed to validate these findings.
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