When it comes to implant surgery, increased advances in dental technology in recent years have further enhanced operational procedures. In particular, guided surgery for dental implants have helped to provide increased precision in outcomes. The most successful results are enabled through the combination of high-quality, 3D anatomical images and accurate prosthetic model fabrication.

Thanks to this combination, dental lab technicians can create hyper-specific implant guides for dental surgeons, helping ensure the best possible restorative results. Have you started incorporating guided surgery into your practice?

guided dental implant surgery

What is “Guided” Dental Implant Surgery?

Guided dental implant surgery leverages the latest imaging technology and tools to achieve optimal results in dental restoration. In non-guided implant placement, a skilled prosthodontist can achieve success using conventional panoramic x-ray imaging for case planning. However, this method has its limitations.

Guided surgery is far more precise, and substantially reduces the risk of human error—especially in more complex cases, where challenges such as bone loss or low sinus cavities, make for particularly complicated procedures. Likewise, guided surgery can prove particularly useful for patients requiring multiple implants or bridgework, as well as implants for retained dentures.

By creating a detailed digital model pre-surgery, the dentist can calculate the ideal position for the implant, and then place it with utmost control and precision. On top of being more precise, this is also a faster, less invasive technique, which moderates post-operative discomfort and swelling.

Technicians gather data from a dental cone-beam computerized tomography (CBCT) scan and a digital impression of the patient’s mouth. Technicians superimpose these digitized models over a 3D representation, guiding crown fabrication and abutment placements. CAD software and computer-aided manufacturing then generates a digital surgical template for the operation. Usually made from clear acrylic, the guide is fitted over existing teeth and/or gum tissue.

Process and Workflow

The process of guided dental implant surgery begins with the very first patient consultation. At this stage clinical assessments and thorough oral examination determine whether implants are even an appropriate treatment. This decision may also hinge on the patient’s overall health, medical history, and any associated risks.

The patient’s mouth is scanned with CBCT, and the resulting 2D images are converted into a 3D digital model. These scans and models include important information about the intraoral anatomy, such as the position of teeth, jawbone, gingiva, sinus cavities, nasal passageways, and key nerves.

After scanning comes the planning. Virtual implant planning software allows prosthodontists to rotate these images, zoom in for greater clarity, and identify any potential problems prior to surgery.

Once given the all clear, it’s time to create the guide. Produced either in-office with 3D printing technology or in an outsourced lab, the surgical drilling guide provides a road map for the operation, enabling accurate implant placement, depth, and angulation.

The subsequent visit is for the surgery itself. The surgical guide is indispensable here: once fitted over the mouth, it shows the surgeon exactly where to secure the implant with minimal trauma. Once the implants are embedded, temporary replacement restorations are fitted. Permanent crowns are then attached once the gums have healed from surgery.

Essential Tools for Guided Implant Surgery

Guided dental implant surgery comes with its own particular set of tools. Specialized drills, stents, taps, sleeves, drivers, software, pins, and other supplemental parts—it truly is its own classification of operation, and requires its own prep from planning through operation.

At the planning stage, guided implant surgery relies on a host of advanced imaging technologies, including CBCT, digital radiographs, optical extra- and intraoral scanners, computer aided design (CAD), implant planning software, and accumulated data in the form of digital wax-ups. Computer-aided manufacturing (CAM) systems then assist in the fabrication of the customized surgical guide.

When it comes time for the procedure itself, there are different types of drilling templates available, depending on the specific surgical technique. For example, in addition to fully guided methods, one can also find surgical adjustment guides for use with a pilot drill alone. The diameter of a guide’s cylinders may also vary.

Surgical guides fall into one of three categories: bone-supported (the most invasive option), tooth-supported, or mucosa-supported. Of the three, the tooth-supported model enables the greatest surgical precision and is most suitable for a wide range of guided surgery needs.

However, wholly edentulous patients will likely be recommended a mucosa-supported guide, which facilitates minimally invasive, flapless surgery. This system requires an occlusion key and a stabilization screw—and possibly fixation pins or screws as well, unless there are temporary implants to assist with positioning. Different sleeve diameters are available, depending on anatomical requirements. A tissue punch kit is also essential tool when performing flapless surgery, in order to minimize physical trauma.

Guided Dental Implant Surgery: Advantages and Challenges

Guided surgery offers a number of advantages over more traditional models and proves a sounder choice on nearly every metric. Technological advances have enhanced our abilities to perform exacting surgery with minimal trauma. As every stage of the surgical journey is pre-planned and visualized, treatments are safer with fewer chances of complication.

Customized guides also result in more exact implant and prosthesis placement, delivering more functional and better outcomes. Patients require fewer visits pre-surgery, and the actual surgical procedure is a lot quicker too.

Compared to more traditional alternatives, guided surgery is also infinitely less invasive. Incisions are smaller, which means less pain, reduced tissue trauma, and quicker healing times. Further, the accuracy of the detailed 3D imaging means lower probability of needing a bone graft down the line.

Guided implant surgery is extremely accurate, improving upon the existing success rate of more than 90% in healthy patients.

That said, guided surgery comes with its caveats. Anatomically, it is difficult to place implants in the posterior areas of the mouth. Access becomes especially problematic when a guide is used and a drill needs to be inserted via the sleeves. Further, a guided approach does not necessarily make the implant procedure easier. Planning and surgical protocol remain highly technical, and its success is wholly reliant on the skill of the practitioner.

Can Guided Surgery Elevate Your Practice?

Dental implants are important not just for aesthetic considerations; they preserve and stimulate bone strength and minimize bone loss. As guided implant technology becomes both more sophisticated and more affordable, it is an increasingly appropriate choice for restorative surgery. Dental implant instruments and tools, implant abutments, impression copings, surgical motors, segmented bridgework, overdentures and partial dentures, temporary crowns and bridges, custom trays, and a variety of materials and laboratory products are all helping to make guided implant surgery more widely available.

Sterngold Dental’s TRU and PUR implant system includes Guided Surgery. The wide range of implant, surgical, and restorative products that we offer provide unmatched performance and value. At the forefront of restorative dentistry since 1897, Sterngold is here to make your practice shine.

Let’s discuss how Sterngold’s restorative products can help your dental practice or laboratory today.