ObjectiveTo study the accuracy of 3D printing implant-guided anterior tooth implantation under flap or flapless surgery.MethodsTwenty-one cases (32 teeth) with missing teeth were divided into two groups: tooth implantation on the maxillary models under flap surgery (FP group) and tooth implantation on the maxillary models under flapless surgery (FPS group). A dental implant guide was designed and used in the two groups. The actual position of the dental implants in the two groups was compared with the preplanned deviation values of implant top, bottom, vertical distance, and angle deviation. SPSS 19.0 software was used for statistical analysis.ResultsThe deviation values of implant top, bottom, vertical distance, and angle were significantly lower in the FP group than in the FPS group (PConclusionHigh accuracy of tooth implantation can be realized by using the 3D printing implant guide. The different surgical methods influence the precision of tooth implantation. Clinicians can choose the surgery reasonably depending on the actual situation.