Advantages and limitations of implant surgery with CAD/CAM surgical guides: A literature review

Abstract

Background: The purpose of this study is to review the available literature associated with implant surgery using computer-aided design/computer-aided manufacturing (CAD/CAM) surgical guides and discuss the advantages and disadvantages of this advanced technique. Material and Methods: An electronic literature search was conducted in the PubMed database for the relevant information on implant placement with CAD/CAM surgical guides. This review was constructed following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Articles were limited to those published within the past 10 years and in the English language. Only clinical studies were included. Inclusion criteria were: studies including 10 implants or more and studies presenting angular deviations in degrees and linear deviations in millimeter. Observational studies, reviews, animal studies, in vitro studies, case reports, simulation studies were excluded. Nine articles were included for qualitative synthesis. Results: The initial search detected 61 articles, and after screening abstracts, a total of 15 articles were selected for full-text review. After the full-text analysis of the 15 articles, six articles were excluded as they did not meet inclusion criteria for study design, study population, and implant placement with data presentation for angular and linear deviations. Ultimately, nine articles providing angular and linear deviations between planned and actual placed implants were used in this review. Common problems that may be encountered by clinicians were listed, and recommendations were made on how to avoid those problems. Conclusions: It has been suggested that although unrealistic expectations are often associated with implant placement with CAD/CAM surgical guides, there is no impeccable accuracy in the clinic. This review demonstrated that the practitioners should be aware of the angular and linear deviations up to 5 ° and 2.3 mm. Therefore, inexperienced dentists should obtain adequate training and be familiar with the basic steps with CAD/CAM surgical guides to avoid complications.

The Modern and Digital Transformation of Oral Health Care: A Mini Review

“…The conventional implant rehabilitation and therapy usually utilizes multiple gypsum casts for medical record and references, in addition to two-dimensional radiographical imaging (periapical and orthopantomogram view) and chairside clinical examination. The inherent disadvantages of this method include far less accuracy in interpretation of the vital anatomical and osseous structures as compared to cone beam computed tomography (CBCT), limited gypsum material properties, potential error-prone manual laboratory procedural, and others [ 37 ]. The development and rapid usage of CBCT imaging in implant therapy has allowed for a more specific and detailed implant site with marked decrease in exposure to radiation.…”

Digital vs. Freehand Anterior Single-Tooth Implant Restoration

“…On the opposite, the choice of guided surgery allows you to completely plan the intervention. Even with the intrinsic limits of this method, for example the precision of CBCT exams or the precision of the surgical masks, there is no doubt that the operations can be performed with a clearly superior reproducibility of some parameters [ 30 , 36 ]. Choosing a digital prosthetic flow allows more advantages.…”

“…Final optical impression was taken to build a screwed zirconia-ceramic crown (Figures 6 and 7 ). All implants were inserted in postextractive mode with a 1.5 mm subcrestal position, to compensate a predictable bone resorption due to tooth extraction [ 30 ]. Immediate loading with screwed temporaries was performed in all patients.…”

Route maps for implant positioning: a review

“…The accuracy and ease of manufacturing have been expanded using interactive treatment planning via CBCT imaging [7][8][9]. Three different surgical guide designs depending on supporting surfaces have been described [10]. They include i. tooth-supported surgical guide is placed on the remaining natural teeth, ii.…”