The use of surgical guides in oral implantology

Abstract

Introduction. In recent years, the development of computer-aided design / computer – assisted manufacture (CAD/CAM) technology has allowed great improvements. Computer assisted approaches have enhanced planning and provided accuracy in transfering the virtual plan to the surgical area, which is higher compared to freehand protocols. Thus, a strong cooperation between the prosthodontist, surgeon, and dental technician through the developed technology can lead to precise treatment planning, predictable, and accurate results. Aim of the study. To assess the applicability of surgical guides in implant-prosthetic rehabilitations of edentulous patients. Materials and methods. The study is based on clinical and paraclinical analysis of 10 patients (4 men and 6 women, mean age 53 ±2.4) with different types of edentulism rehabilitated using dental implants by All-on-4 concept. The virtual planning and surgical guide printing were made using the Blue Sky Plan software. A special attention was paid to the positioning of the distal angulated implants in close proximity to the mental foramen. The postoperative CBCT was analysed to appreciate the accuracy of the obtained position of implants upon initial treatment plan. Results. The results were uneventful. All the implants were installed according to the initial plan made by the medical team. However, in one case, due to a short passive part of the surgical guide and a small number of teeth supporting it, the drilling process required complementary checking of the implants area due to the moving of the surgical guide. Another difficulty was observed during the drilling process of the distal implants caused by the height of the guiding drills and the limited mouth opening. Conclusions. The use of surgical guides in implants placement lead to a good and precise positioning of implants especially in cases with limited bone offer. This method allows to insert implants in exact required angulation and to avoid some complications like nerve damage. However, appropriate design of the surgical guide as well as the local limitations of the mouth should be taken into consideration in order to achieve the desired results.