Dental implants have become so popular that more than 5 million implants are placed each year by dentists in the United States alone. However, it is generally observed that a majority of implants are placed in a less-than-ideal manner. Computer-guided surgeries are proven to have a positive impact on implant placement as well as implant treatment planning. But, despite the indisputable compensations, only a partial number of clinicians regularly practice directed transplant surgery nowadays. This article aims to examine the challenges in guided implant surgery and how a novel concept of the open guide is trying to solve these issues. The latter was used during a CT scan and was eventually converted into an actual surgical guide. However, using conventional guides is not a guarantee for proper implant placement. The reason for that was inherent in their design. Conventional guides take marvelous leeway in the drilling trajectory and no drilling depth control. Using them relies on several variables that may not be trustworthy, such as hand stability, patient immobility, and another person’s feedback on the drilling angle. Bone quality can also affect the osteotomy in situations of immediate implant placement, as the drills commonly bounce off dense bone affecting the angulation and point of entry. From a safety perspective, conventional guides do not consider the patient’s relevant anatomy.

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