The objective of this article was to review the different factors and limitations influencing the accuracy of computer-aided implant surgery. In vitro and in vivo accuracy studies of articles and congress proceedings were examined. Similar results using bur tracking as well as image-guided template production techniques have been reported, and both methods allow for precise positioning of dental implants. Compared to the conventional technique, this sophisticated technology requires substantially more financial investment and effort (computerized tomographic imaging, fabrication of a registration template, intraoperative referencing for bur tracking, or image-guided manufacturing of a surgical template) but appears superior on account of its potential to eliminate possible manual placement errors and to systematize reproducible treatment success. The potential for the protection of critical anatomic structures and the esthetic and functional advantages of prosthodontic-driven implant positioning must also be considered. However, long-term clinical studies are necessary to confirm the value of this strategy and to justify the additional radiation dose, effort, and costs. (More than 50 references) (Literature Review) Keywords: dental implant surgery, image-guided bur tracking, image-guided template production