Free-Hand versus Surgical Guide Implant Placement

Abstract

One of the most key areas of dentistry is dental implant surgery. The use of digital equipment and software in dentistry has developed considerably in recent years compared to other fields of medicine. Since examining the advantages and disadvantages of each approach, along with case studies, can help physicians make informed decisions, this review study aims to raise the awareness of dentists to make easier decisions about using guided or free-hand surgery. When planning for a dental implant, one of the most challenging questions that doctors face is which method to use (guided surgery or free-hand). Choosing the right method, such as other clinical considerations, will depend on the individual circumstances of each patient and the preference of the treating physician. Free-hand surgery is a cost-effective method in which the flap is reflected, and, according to the doctor's diagnostic information, an implant is placed, which in many cases is a useful method. Guided surgery has the highest level of accuracy and control, in which osteotomy is designed and printed through a digital surgery guide, and depending on the complexity of the case and the patient's anatomy, it has a higher level of value than free surgery. The surgical guide helps the surgeon make the implant surgery more accurate, safer, simpler, at a lower cost, and in less time. In fact, there are patterns that convey information about the position of the tooth to the dentist before the implant is placed.

FEM Analysis of Individualized Polymeric 3D Printed Guide for Orthodontic Mini-Implant Insertion as Temporary Crown Support in the Anterior Maxillary Area

“…The base resting on the teeth and the angulation of the guiding cylinder need to be modified according to the characteristics of each individual case. Although free-hand when compared to the guided technique of mini-implant placement eliminates the time required to digitally plan the guide and reduces the cost of printing, the advantages of using surgical guides overcome these limitations [ 20 , 21 ]. Free-hand insertion requires a longer clinical procedure given that the clinician is planning the position of the implant on the spot.…”

“…Thus, the risk of human error is higher with less predictable results which can cause complications for the patient (infection, implant failure, incorrect positioning, swelling, pain) [ 42 ]. Studies have shown that guided insertion addresses all the above risks, decreasing surgery time and providing more accurate results [ 20 , 24 , 27 , 28 ]. The application of this protocol has great advantages in nonstandard cases like the one described in the present study (space loss, singular missing teeth, aesthetic area, alveolar crest resorption).…”

“…The application of this protocol has great advantages in nonstandard cases like the one described in the present study (space loss, singular missing teeth, aesthetic area, alveolar crest resorption). This method is also recommended for beginner clinicians due to the high success rate and reduced failure, which could cause higher costs than the cost required for surgical guide fabrication [ 20 ]. No studies have addressed the comfort level of patients during these procedures, but provided that the guide simply rests on the neighboring teeth, this should not be considered a limitation.…”

“…In free-hand surgery, 2D or 3D radiographs are usually used to assess the alveolar bone available to place the implant and examine the surrounding anatomical structures. The intraoral examination is also a part of the planning stage with periodontal probes or calipers being used to provide the surgeon with a view of the height and thickness of the ridge [ 20 ]. The adjacent teeth can be used as a guide for determining the correct insertion site and position of the mini-implant.…”

Biomechanical evaluation of implant system fixed dentures support in atrophic maxilla

“…Due to technological advances, research indicates that rehabilitation with implants of atrophic mandible offers a minimally invasive approach, reduced number of surgical interventions, reduction of the total treatment time, reduced treatment costs and increased acceptability 4,5 . Some authors noted that treatment planning and delivery was facilitated and optimized with the aid of digital technologies (CAD/CAM) 6 , since it allowed the reduction of complications during the installation of implants and in prosthetic rehabilitation with reduction of risks, costs, number of treatment sessions 7 .…”