Implant Surgical Guides – How They Are Made and Why We Use Them

A model of a surgical implant.

What is an implant surgical guide?

An implant surgical guide allows a dental surgeon to place an implant in a very specific, pre-planned location to give the most ideal depth, angulation, and size of implant to fit the space. It is essentially a hard acrylic mouthguard that fits over the adjacent teeth to keep it stable. It has one or more metal cylinders embedded in the acrylic that guides each successive implant drill through the opening and allows it to only go in one location, and to one depth, allowing the implant to be placed very accurately and safely.


Why use a surgical guide?

Before implant surgical guides were invented, or in cases where a dentist can’t or doesn’t want to use a guide, the surgeon placing an implant would have to open the gums and assess the bone width at the time of surgery. They would use this information along with a 2D x-ray to determine the approximate distance to important structures like nerves, the floor of the nose, or sinuses to determine how wide and long of an implant can be placed to avoid these anatomical structures, while still giving enough retention. Sometimes after a few months of healing occur and it’s time to put a crown on top of the implant, the dentist finds that the implant isn’t in the most ideal location to place a crown on top. This can make it quite challenging to give a natural shaped tooth and can lead to issues of difficulty cleaning, food becoming stuck, or a less than desirable appearance as a result of an odd shape or emergence of the crown from the gums. With a surgical guide, the final crown of the tooth is digitally designed by a dentist to be in the most ideal location relative to the other teeth, the tongue, and the lips. By combining this digital tooth information with the 3D x-ray (called a CBCT), an implant with the most ideal width and length can be selected and placed digitally into the most ideal location in the bone, all before the surgery even begins. By doing this planning with the end goal in site, it makes the surgery faster and easier to get a more ideal result and makes any potential issues easier to detect and correct before the surgery.


What is the process of making an implant surgical guide?

The process begins with a digital impression of the top and bottom teeth or dentures when possible (although some cases involving patients with many metal fillings and crowns do require us to take a physical impression to make stone models). We then take a CBCT x-ray to get a 3D image of the teeth where we plan to place implants. We can then use special software to combine the 3D x-ray with the 3D impression of the teeth after we digitally design and add in teeth to the spaced where implants are to be placed. From here, the dentist digitally selects which length and width of implant is most ideal and sets it in the most appropriate depth and angulation to be best suited for the crown that will eventually be placed onto the implant after healing is done. The process is fast, safe, and pain free.





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