Planning with a 3D scan
Cone beam computed tomography (CBCT) is a cross-sectional (3D) imaging method.1 The American Academy of Oral and Maxillofacial Radiology recommends cross-sectional imaging for all dental implant sites and names CBCT as the imaging method of choice.1 The ITI Group 5 consensus (2018) found that the accuracy of measurements on CBCT scans depends on the software used.2
Static guides
In static guided surgery, the implant position is planned on the computer and transferred to surgery with a fixed surgical guide.3
An ITI meta-analysis of 20 clinical studies with 2,238 implants in 471 patients measured how close the placed implant came to the plan.3
| Measure | Mean deviation |
|---|---|
| At the entry point | 1.2 mm |
| At the implant tip | 1.4 mm |
| Angle | 3.5 degrees |
Guides were more accurate in partially edentulous cases than in fully edentulous cases.3 The authors recommended a safety margin of at least 2 mm.3
The ITI consensus found static guided surgery beneficial compared with conventional surgery for pain and discomfort, economics and intraoperative complications.2 It also noted that flapless guided surgery can place implants outside the zone of firm gum tissue and must be done with care.2 The consensus described guided surgery as an additional tool for diagnosis, planning and surgery.2
Dynamic navigation
Dynamic navigation (dynamic computer-aided implant surgery) is a second computer-guided method.4 A meta-analysis of 24 studies covering 9 navigation systems found the following in clinical studies.4
| Measure | Mean deviation |
|---|---|
| Angle | 3.68 degrees |
| Entry point | 1.03 mm |
Dynamic navigation was more accurate than freehand placement and slightly more accurate in angle than static guides.4 The authors also recommended a 2 mm safety margin.4
Robotic guidance
Robot-assisted systems are a third approach; see the robotic surgery topic.5
Questions to ask
- Will a CBCT scan be taken before surgery.
- Will the implant be placed freehand, with a guide, with navigation or with a robot.
- Who designs the plan, and is the restoration planned before the implant position.
General information about dental implants. Treatment decisions are made with a licensed dentist.
Sources
- Tyndall DA et al. AAOMR position statement on selection criteria for radiology in dental implantology with emphasis on CBCT. 2012. pubmed.ncbi.nlm.nih.gov
- Wismeijer D et al. Group 5 ITI Consensus Report: Digital technologies. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Tahmaseb A et al. Accuracy of static computer-aided implant surgery: systematic review and meta-analysis. Clin Oral Implants Res 2018. pubmed.ncbi.nlm.nih.gov
- Jorba-Garcia A et al. Accuracy of dynamic computer-aided implant placement: systematic review and meta-analysis. Clin Oral Investig 2021. pubmed.ncbi.nlm.nih.gov
- Alqutaibi AY et al. Robot-assisted dental implant surgery: systematic review of clinical evidence. J Prosthet Dent 2026. pubmed.ncbi.nlm.nih.gov
