3D Printed Guides for Implant Surgery: better accuracy?

Careful treatment planning before placing implants is essential for ensuring a successful outcome. The use of surgical guides has become popular in implant dentistry, simply because they make implant placement and restoration more predictable. With the growing advancement in technology, it is now possible to use desktop 3-D printers with intraoral scanning and implant planning software, to fabricate surgical guides in-office. But, how accurate are these guides and how does fully-guided surgery with these guides compare to the alternative? A recent study 1, was done to determine the accuracy of tooth-supported guided implant surgery using desktop printed stereolithographic (i.e. 3D Printed) guides. A cross-sectional study comparing fully and partially guided implant surgery was conducted.

The authors conclude that:

The difference between the variances for fully and partially guided surgery for the distal and angulation dimensions was statistically significant…Anterior implants had less variation in deviation than posterior implants…Fully guided implant surgery is more accurate than partially guided implant surgery. Implant positional deviation is influenced by implant location but not implant systems or software. If possible, clinicians should use guided surgery protocols that allow placement of implants through a surgical guide.Read More

In another study 2 conducted late last year, a different group of authors concluded that:

In-office fabricated stereolithographic implant surgical guides show similar accuracy to laboratory- or manufacturer-prepared guides. This technique provides a convenient and cost-effective means of assuring proper implant placement.2

Is anyone using a 3-D printer in their office now to fabricate surgical guides? If so, do you feel this has improved your treatment planning and outcomes? What are your thoughts on the future of in-office 3-D printing of guides?

1.In Vivo Tooth-Supported Implant Surgical Guides Fabricated With Desktop Stereolithographic Printers: Fully Guided Surgery Is More Accurate Than Partially Guided Surgery..J Oral Maxillofac Surg. 2018 Jul;76(7):1431-1439. Bencharit S.

2.How Accurate Are Implant Surgical Guides Produced With Desktop Stereolithographic 3-Dimentional Printers?J Oral Maxillofac Surg. 2017 Dec;75(12):2559.e1-2559.e8. Deeb GR

4 Comments on 3D Printed Guides for Implant Surgery: better accuracy?

New comments are currently closed for this post.
andrew
7/10/2018
Check out blue sky plan from blue sky bio .......... they have great guys working there and some really affordable online courses offered by specialist dentists and general dentists .......... Rick Ferguson, Michael Scherer, Baron Grutter to name a few .......... look them up.
JASON LARKIN
7/10/2018
Absolutely love surgical guides. I have been watching Blue Sky Bio program grow for the past 5 years. So proud of their accomplishments and all their efforts in making guided surgery so easy and affordable. I encourage you to join BSB Facebook group and see the planned and placed overlays. Very accurate. I print my own surgical guides with a Form 2 printer and placement guides at my home. I would say guided implants are usually within 0.5 to 1mm of planned placement. One must always remember though that guided surgery is a powerful tool but you must be able to free hand or osteodensify as needed. I probably spend 4 times longer thinking about all the complications that could happen and how to treat those. Planning the guide only takes 10 minutes and is fun. I charge $130 to my patients for my guides. I use Dr. Cory Glenn's alginate impression technique with radiographic beads as a radiographic guide. I charge $59 for that. I charge $89 for the Cbct scan. Then scan model with DOF UHD lab scanner. Merge. Plan. Print. Place. Post op low dose cbct. Overlay to see accuracy. Fun stuff.
Justinas
7/14/2018
Nice protocol doc! How do You are doing overlay, with the same bluesky?
LSDDDS
7/11/2018
There has been past mention herein of diminished ability to irrigate surgical site with guide vs freehand. Any opinions?

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