Dental implants can provide a permanent solution to the problem of tooth loss. However, the invasive and often time-consuming nature of implant procedures may be off-putting to many nervous patients. Thankfully, innovations like computer and AI advancements are making guided surgery a practical, less time involved, and more accurate option for dental implant placement, and can serve to assuage fear of the procedure from patients.

An increasing number of dental practices employ guided surgery to perform implant procedures with greater precision and accuracy. How might guided dental implant surgery benefit your practice?

guided dental implant surgery overview

The Principle of Guided Surgery

Guided dental implant surgery leverages modern technology to assist in correctly placing and angulating dental implants. This computer-aided implantology (CAI) may include tools such as digital x-rays, 3D imaging, computerized topography (CT) scans, computer aided design (CAD), and computer aided manufacturing (CAM).

The technology has come a long way since 1999, when the first digital, bone-supported guides were used to treat wholly edentulous patients. Tomodensitometric x-rays have immensely improved accuracy since then, allowing for better differentiation of bony areas from soft tissues. Fast-forward to 2022, and now fully-digital lab models and intra-buccal impressions are streamlining implant surgery like never before imagined.

The goal of guided dental implant surgery is to improve patient outcomes through more accurate and less invasive techniques.

Modern Imagining Technology

Modern guided surgery relies on the latest hardware and software, with machinery and imaging technology generating highly accurate anatomical information. This results in minimally intrusive procedures, delivered over much-reduced timelines.

Technicians superimpose and integrate radiological images (produced by a scanner or cone beam x-ray) and clinical data (via intraoral digital impressions of the patient’s mouth and surgical implant site) with 3D implant planning systems to produce a detailed surgical guide. When synchronized with a virtual wax-up of the prosthetic element, these tools allow for a now 100% digital planning process!

3D imaging technology and CAD software fabricates models of the prostheses. From these models, the dental lab can then design restorations utilizing CAM software. The crowns are then placed on the implants with digital x-rays taken to aid their proper placement.

The surgical guide provides a digital replication of intraoral surfaces to help dental surgeons drill into bone with extreme accuracy. Once placed, the device’s cylindrical titanium sleeves assist in directing the surgical instruments and correctly positioning the implant.

Surgeons have their pick of various surgical guides, including those supported by teeth, soft tissue, or bone. The type of guide chosen depends on the patient’s specific needs and treatment plan.

Freehand vs. Guided Implants

Whether you opt for freehand or guided dental implant surgery is largely determined by your patient’s unique circumstances. Factors such as anatomical features, bone density, the number of implants required, and the practitioner’s experience all play a part in the decision. Further, the type of surgery chosen will impact a variety of aspects, from treatment planning and diagnostic evaluation to cost and patient comfort.

Both freehand and guided procedures have their place in current dental implant practice. For example, freehand placement is optimal in single-implant cases performed by an experienced practitioner. Meanwhile, guided surgery is more appropriate and can improve precision for operations involving multiple implants.

Guided Dental Implant Surgery

Implant positions—including precise depth, angulation, and the buccal-lingual location of the implant osteotomy in the bone—are pre-planned in guided surgery. This offers maximal accuracy and control, and ensures that the ideal site is chosen relative to other teeth, the tongue, and the lips.

The degree of planning that goes into the procedure renders the surgery quicker to perform. Moreover, the added focus on providing a perfectly positioned and angulated implant is likely to deliver a more aesthetically pleasing outcome.

Guided surgery is particularly suitable for complex cases with limited anatomical space (for example, tight positioning of the patient’s sinus, adjacent teeth, or inferior alveolar nerve).

Freehand Surgery Procedures

Like guided surgery, a freehand procedure involves some pre-planning—such as x-rays and impressions—as well as cone beam CT to create 3D images of the intraoral space. However, more traditional methods such as physical molds may not provide as high a degree of accuracy for the placement, size, and shape of the implant and crown. No matter how skilled the practitioner, without up-to-date imaging technology, gauging the best positioning for implants and crowns can prove difficult.

Although freehand surgery is historically the more cost-effective approach, technological advances have resulted in guided approaches becoming markedly more affordable. What’s more, while freehand might suffice for straightforward procedures, it’s highly advisable to consider guided surgery in cases where there are potential complications.

The Benefits of Guided Dental Implants

Once relegated to only the most complex procedures, guided implant surgery is now a viable option across a variety of treatment plans. Guided dental implant surgery offers many benefits, for both practitioner and patient. From quicker operational time, to heightened accuracy and better long-term fit, guided surgery presents many advantages that make it the clear next step for dental implant installation.

Less Time in Surgery

Surgical guides created from detailed 3D scans and radiography provide dental practitioners with a clear plan of action. This in turn allows for a smoother, faster procedure. Moreover, flapless surgery is less invasive, and therefore leads to less trauma, quicker recovery times, and reduced post-operative swelling and discomfort.

Lower Risk

Digital imaging provides a comprehensive picture of the patient’s tooth, jaw, and tissues, allowing practitioners to view vital anatomical structures accurately. This boosts placement precision and improves the safety of the procedure, minimizing the possibility of complications during surgery. Better placement also leads to increased implant longevity.

Improved Placement in Jawbone

Computer-aided technology generates high-quality 3D images of a patient’s jawbone. This information is vital when dealing with bone that has atrophied and decreased in volume as a result of long-term tooth loss. Depicting the available bone faithfully optimizes the placement of implants and is critical to restoration success.

Better for Multiple Sequential Implants

When performing several implants in quick succession or an extraction followed immediately by implant placement, accuracy is essential. For this reason, fully or partially edentulous patients can benefit immensely from guided surgery.

Flexibility to Manage Difficult Placements and Existing Implants

Having a complete picture of the planned restoration allows practitioners to make adjustments—such as using custom abutments—to place implants in suboptimal locations. Further, guided dental implants are the best choice for patients with existing implants or other teeth in close proximity to the planned operating site.

guided dental implant surgery

Some Myths Regarding Guided Dental Implant Surgery

No matter how impressive the technology, the most important consideration for dental implant surgery is the final result. Guided surgery makes leaps and bounds in accuracy over older, freehand methods. Despite this, however, a number of myths continue to circulate about the efficacy of guided surgery.

Myth: There is little difference between guided and traditional techniques

Despite some common elements, the two methods use vastly different tools and equipment. For example, specialized instrumentation and materials required for guided dental surgery include specialized trays, implant mounts, drill stops, burs, and even the implants themselves. Guided surgery relies more on computer imaging in order to enhance accuracy.

Myth: Guided surgery decreases overall chair-time for the patient

Actual surgery time is quicker with a guided procedure. However, the treatment path takes longer overall, because of the time involved in digital imaging, impression taking, specialized tomography, and planning.

Myth: Guided surgery is easier than freehand surgery

Guided surgery is more accurate, not easier. Far from being a simple technique, it requires a skilled and experienced surgeon because of the complex processes and organization required.

Myth: Guided surgery is only for difficult cases

Although guided surgery was once reserved for fully edentulous patients and other tricky cases, today there are a number other reasons such surgery may be preferred. As discussed above, this depends on a variety of factors, including the need for quick recovery from surgery as well as the lower risk profile of guided implant surgery.

Myth: Implants don’t work for older people

Age is not an issue that determines whether or not a patient is a good candidate for implant surgery. More important factors include jawbone strength and health of the gum tissue.

Myth: Implants are painful

The implant surgery occurs while the patient is under anesthesia or sedation, or even with the help of nitrous oxide. Although patients may feel a little post-op tenderness, this is usually successfully managed with pain medication.

Optimizing Your Outcomes

Your patients might not be dental experts, but they understand the advantages of a surgical procedure that’s less invasive, offers faster recovery, and results in lower levels of discomfort overall. Depending on their particular clinical circumstances, guided dental implant surgery might offer them the best possible outcome.

As the uptake of guided implant surgery increases, Sterngold is ready to meet the moment with an ever-widening range of dental products. From dental implant systems, instruments, and tools to custom trays, restoration materials, and laboratory products, Sterngold is here to make guided dental implant surgery a viable and accessible option for all patients.

As pioneers in dental restoration since 1897, we at Sterngold Dental pride ourselves on providing the best dental tools, procedures, and products for dental practices and labs. With extensive continuing education courses, we also aim to ensure practitioners are experts in the field—on top of having the best products. Reach out to Sterngold to find how our range of competitively-priced implant products and treatments can enhance your practice today!