The Relationship Between Biologic Concepts and Fabrication of Surgical Guides for Dental Implant Placement

Gary Greenstein, DDS, MS; John Cavallaro, DDS

April 2007 Issue - Expires Thursday, April 30th, 2009

Compendium of Continuing Education in Dentistry

Abstract

This article reviews guidelines for construction of surgical guides to direct dental implant placement. Biologic principles are discussed with regard to the mesiodistal, buccolingual, and apicoronal insertion of implants. The application of these data to develop surgical guides is discussed. Also, with respect to specific prosthetic reconstructions, a variety of guides are described that can be fabricated for partially and fully edentulous arches.

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Fig 1. Improper implant placement could have been avoided by using a surgical guide.

Figure 1

Fig 2. Properly designed surgical guides can lead to proper implant placement.

Figure 2

Fig 3. The guiding cylinders (A) and the contact surface (B) in a surgical guide.

Figure 3

Fig 4. Surgical guide with partially limiting design.

Figure 4

Fig 5. Radiographic guide with radiopaque tooth.

Figure 5

Fig 6. Radiographic guide ready to be converted to a surgical guide.

Figure 6

Fig 7. Surgical guide with completely limiting design.

Figure 7

Fig 8. The CBCT scan and the scan from the cast are overlapped to plan the surgery.

Figure 8

Fig 9. 3D-printed surgical guide created with CAD/CAM technology.

Figure 9

Figure 10. 3D-printed surgical guide created with CAD/CAM technology.

Figure 10

Figure 11. Mucosa-supported surgical guide.

Figure 11

Figure 12. Radiographic guide with radiopaque teeth for a fully edentulous patient.

Figure 12

Figure 13. Panoramic image rendered from CBCT cross sections in a patient with mucosa-supported radiographic guide.

Figure 13

Figure 14. Placing implants exactly where the diagnostic wax-up dictates is not always possible.

Figure 14

Figure 15. The treatment planning for implant placement should be done with an interdisciplinary approach to know the surgical and prosthodontic limitations.

Figure 15

Learning Objectives:

Disclosures:

The author reports no conflicts of interest associated with this work.

Queries for the author may be directed to justin.romano@broadcastmed.com.

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