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Guided Surgery

In the past, when one thought of traveling, the first thing that came to mind was the way to the destination, and if it was your first visit? You would carry a paper map, a little clumsy to read and understand. However, if someone on the way guided you, your job eased out, and reaching your intended destination was hassle-free and faster.

Likewise, in dental implant surgery, placement largely relied on skills acquired, practice experience, and surgeon’s acumen. Additionally, the implants placed in the jaw were based on bone availability and abundance. This caused considerable difficulties in the delivery of the final prosthesis supported by the implants.

Nevertheless, a recent change has led to the consideration of superstructure in pre-surgical planning itself.

Additionally, the evaluation of 3D Data- extracted from CBCT and an optical scanner, together with modern implant planning software. One can simulate surgical and prosthetic phases.

This is analogous to the present-day use of dynamic map apps on our smartphones. With the real-time information guiding us to travel with ease and reach the exact location intended.

The correct location is the most crucial aspect of fulfilling both functional and aesthetic success, even in implant surgeries.

Here are some research-based recommendations on the selection of the modality based on clinical situations.

  1. Free Hand Implant Surgery
  2. Recommended in Single missing teeth. Narrow edentulous spaces, usually less than 11 mm. The surgeon with 3 or more years of experience. The shortcoming is the high possibility of implants placed close to the root of adjacent teeth.

  3. Computer Navigated Implant surgery
  4. Computer Navigated Implant Surgery has benefited from the advances of the Digital revolution and evolved towards newer devices that use real-time tracking technology. It is seen to be precise, predictable, and safe. Implant placement is done flapless, transmucosal, in the interforaminal region (anterior to the mental foramen) with a smooth, wide, and regular mandibular ridge applying the principles of minimally invasive surgery. However, studies infer that computer navigated implant surgery has no significant difference when compared to computer-guided surgery.

  5. Computer-Guided Implant surgery
  6. It is performed with a surgical guide or a template, recommended in cases with incomplete bone remodeling and splayed roots sometimes seen in lower molars. It can be used to counteract the tendency of the drill to be driven off course toward the newly formed bone. Other applications are in multiple-implant cases, having completely edentulous or long span partially edentulous arches.

    Different types of stents or surgical guides are:

    • Tooth-supported surgical guides: Partially edentulous cases
    • Mucosa-supported surgical guides: positioned on top of the mucosa. (Fully edentulous cases)
    • Bone-supported surgical guide: in cases where more extensive (bone) surgery is required.
    • Special supported, (mini) implant, pin-supported surgical guides: the surgical guide is attached to (mini) implants planned to insert before or during the actual implant surgery.

Studies suggest greater accuracy could be achieved when reference mini-implants were used, but the accuracy was least with the bone supported surgical guides.

The most recent developments in the production of surgical guides is based on the superimposition of digital CT data and intra-oral scanning data. With mutually overlapping landmarks on both digital images, such as part of the teeth, guides are designed and fabricated with CAD/CAM technology followed by 3D printing or milling. This novel approach improves positioning and accuracy in terms of the relationship between virtually planned and real-life insertion of the implant.

The dentists planning to practice oral Implantology in this era of Digital Dentistry can utilize the latest technology, research-based recommendations, and reliable services to place implants predictably with greater accuracy using Teeth-supported Surgical Guides from our Dental laboratory.