Surgical templates for dental implant positioning; current knowledge and clinical perspectives

Abstract

Dental implants have been used in a variety of different forms for many years. Since the mid-20th century, there has been an increase in interest in the implant process for the replacement of missing teeth. Branemark was one of the initial pioneers who applied scientifically based research techniques to develop an endosseous implant that forms an immobile connection with bone. The need for a dental implant to completely address multiple physical and biological factors imposes tremendous constraints on the surgical and handling protocol. Metallic dental implants have been successfully used for decades, but they have serious shortcomings related to their bony union and the fact that their mechanical properties do not match those of bone. However, anatomic limitation and restorative demands encourage the surgeon to gain precision in planning and surgical positioning of dental implants. Ideal placement of the implant facilitates the establishment of favorable forces on the implants and the prosthetic component as well as ensures an aesthetic outcome. Therefore, it is advisable to establish a logical continuity between the planned restoration and the surgical phases, it is essential to use a transfer device that for sure increases the predictability of success. The surgical guide template is fabricated by a dental technician after the presurgical restorative appointments that primarily include determination of occlusal scheme and implant angulations. Here, authors genuinely attempted to review the evolution and clinical applicability of surgical templates used in the placement of dental implants.

The Effectiveness of Osseodensification Drilling Protocol for Implant Site Osteotomy: A Systematic Review of the Literature and Meta-Analysis

“…The evolution of the techniques and materials adopted has allowed more doctors and patients to use this type of therapy, making possible the placement of implant elements in very hard situations where only a few years ago the professional would have chosen a different therapeutic choice [ 36 ]. One of the main principles for successful therapy is the achievement of suitable primary stability during the implant placement [ 37 ] in respect to the biology of the host [ 38 ] and factors depending on the invasiveness of the operation; the more the preparation of the implant site will be performed in an atraumatic way by avoiding the overheating, and so the necrosis of the site, the more we will be able to respect tissues of the host by avoiding intra- and post-operation complications (bleeding, swelling, local infection, invasion of the noble structures adjacent to the surgery, implant early loss, inadequate healing of hard and soft tissues involved during the operation, presence and/or formation of pus immediately after the operation, pain, alteration of the sensitivity of the area) [ 39 , 40 , 41 ].…”

Drill bit guiding system for implant placement

“…The accuracy of the implant placement for the determined angulation was 0.048% with a standard deviation of 0.391. The CAD/CAM stent[8910] evaluated implant placement accuracy for angulations using a laser probe and showed a mean mesiodistal angle deviation of 0.7 (±5.02) degree and buccolingual angle deviation of 0.46 (±4.43) degree. The entrance point variation was 0.2 (±0.72) in which 85% implants were within <1 mm from the planned position with a <7 degree deviation on buccolingual and mesiodistal angulation in 88% and 91% placed implants, respectively.…”

Computer-Assisted Technique for Surgical Tooth Extraction

“…However, modifying the treatment plan to simulate the tooth extractions or bone modifications should be done if necessary. Optionally, the surgical guide could be manufactured based on the master model; but, in the proposed method, the master model is used only for validating the final outcome [ 9 ].…”