Skip to main content

Advertisement

SpringerLink
Log in

Dental Implant Surgery: From Conventional to Guided to Navigated Approach

  • Digital and Esthetic Dentistry (E Anadioti and P Stathopoulou, Section Editors)
  • Published:
Current Oral Health Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this article is to review the evolution of dental implant surgery from a traditional approach to a computer-aided one. Implant surgery using CAD/CAM surgical templates has become widely used, and now, a new technology, dynamic navigation, is gaining popularity. We aim to review both technologies as well as their advantages and disadvantages.

Recent Findings

The latest reviews of the accuracy of static navigation show 1.4 mm apical horizontal, 1.1 mm coronal horizontal, 0.74 mm vertical, and 3.98° angular deviations. Dynamic navigation is reported to have 0.4 mm horizontal/vertical and 4° angular deviations. While deviations do exist with these techniques, the accuracy and predictability still greatly surpass that of free-hand surgery.

Summary

Dentistry has now moved into a digital era and so has implant surgery. Computer-aided implant planning and surgery has become common practice for many surgeons. Static and dynamic navigation has taken implant surgery to a new level of predictability and precision.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ring ME. Dentistry: an illustrated history 2nd ed: Abradale Press; 1985.

  2. Misch CE. Contemporary implant dentistry: Mosby Elsevier; 2007.

  3. Greenfield EJ. Implantation of artificial crown and bridge abutments. Int J Oral Implant. 1991;7(2):63–8.

    CAS  Google Scholar 

  4. Brånemark PI, Hansson BO, Adell R, et al. Osseointegrated implants in the treatment of the edentulous jaw: experience from a 10-year period. Scand J Plast Reconstr Surg. 1977;16:1–132.

    Google Scholar 

  5. Brånemark PI. Osseointegration and its experimental background. J Prosthet Dent. 1983;50(3):399–410. https://doi.org/10.1016/S0022-3913(83)80101-2.

    Article  PubMed  Google Scholar 

  6. Esposito M, et al. Interventions for replacing missing teeth: different types of dental implants. Cochrane Database of Syst Rev. 2014;(7):CD003815.

  7. Esposito M, et al. Interventions for replacing missing teeth: dental implants in zygomatic bone for the rehabilitation of the severely deficient edentulous maxilla. Cochrane Database Syst Rev. 2013:CD004151. https://doi.org/10.1002/14651858.CD003603.pub3.

  8. Chen Y, Kyung HM, Zhao WT, Yu WJ. Critical factors for the success of orthodontic mini-implants: a systematic review. Am J Orthod Dentofac Orthop. 2009;135(3):284–91. https://doi.org/10.1016/j.ajodo.2007.08.017.

    Article  Google Scholar 

  9. Branemark PI, Zarb G. Tissue-integrated prostheses: Quintessence Books; 1989.

  10. Branemark PI and Worthington P: Advanced osseointegration surgery: applications in the maxillofacial region. Brånemark PI, Zarb, George A, Albrektsson T, editors. Quintessence Books; 1992.

  11. Gupta S, et al. Oral implant imaging: a review. Malays J Med Science. 2015;22(3):7–17.

    Google Scholar 

  12. Karjodkar FR. Textbook of dental and maxillofacial radiology. 2nd ed: Jaypee Brothers Medical Publishers ℗ ltd; 2009.

  13. Guerrero ME, Noriega J, Castro C, Jacobs R. Does cone-beam CT alter treatment plans? Comparison of preoperative implant planning using panoramic versus cone-beam CT images. Imaging Sci Dent. 2014;44(2):121–8. https://doi.org/10.5624/isd.2014.44.2.121.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Bornstein M, Scarfe W, Vaughn V, Jacobs R. Cone beam computed tomography in implant dentistry: a systematic review focusing on guidelines, indications, and radiation dose risks. Int J Oral Maxillofac Implants. 2014;29(Supplement):55–77. https://doi.org/10.11607/jomi.2014suppl.g1.4.

    Article  PubMed  Google Scholar 

  15. Deeb G, Antonos L, Tack S, Carrico C, Laskin D, Deeb JG. Is cone-beam computed tomography always necessary for dental implant placement? J Oral Maxillofac Surg. 2017;75(2):285–9. https://doi.org/10.1016/j.joms.2016.11.005.

    Article  PubMed  Google Scholar 

  16. Ramasamy GM, et al. Implant surgical guides: from the past to the present. J Pharm Bioallied Sci. 2013;5(Suppl 1):S98–S102.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Arfai NK, Kiat-amnuay S. Radiographic and surgical guide for placement of multiple implants. J Prosthet Dent. 2007;97:310–2. https://doi.org/10.1016/j.prosdent.2007.03.002.

    Article  PubMed  Google Scholar 

  18. D'Souza KM, Aras MA. Types of implant surgical guides in dentistry: a review. J Oral Implantol. 2012;38(5):643–52. https://doi.org/10.1563/AAID-JOI-D-11-00018.

    Article  PubMed  Google Scholar 

  19. Rungcharassaeng K, Caruso JM, Kan JYK, Schutyser F, Boumans T. Accuracy of computer-guided surgery: a comparison of operator experience. J Prosthet Dent. 2015;114(3):407–13. https://doi.org/10.1016/j.prosdent.2015.04.004.

    Article  PubMed  PubMed Central  Google Scholar 

  20. •• Bover-Ramos F, et al. Accuracy of implant placement with computer-guided surgery: a systematic review and meta-analysis comparing cadaver, clinical, and in vitro studies. Int J Oral Maxillofac Implants. 2017; Not yet in print. This is the most current review of the accuracy of static navigation.

  21. Arısan V. Implant positioning errors in freehand and computer-aided placement methods: a single-blind clinical comparative study. Int J Oral Maxillofac Implants. 2013;28(1):190–204. https://doi.org/10.11607/jomi.2691.

    Article  PubMed  Google Scholar 

  22. Cassetta M, Giansanti M, di Mambro A, Calasso S, Barbato E. Accuracy of two stereolithographic surgical templates: a retrospective study. Clin Implant Dent Relat Res. 2013;15(3):448–59. https://doi.org/10.1111/j.1708-8208.2011.00369.x.

    Article  PubMed  Google Scholar 

  23. Pettersson A, Komiyama A, Hultin M, Näsström K, Klinge B. Accuracy of virtually planned and template guided implant surgery on edentate patients. Clin Implant Dent Relat Res. 2012;14(4):527–37. https://doi.org/10.1111/j.1708-8208.2010.00285.x.

    Article  PubMed  Google Scholar 

  24. Turbush SK, Turkyilmaz I. Accuracy of three different types of stereolithographic surgical guide in implant placement: an in vitro study. J Prosthet Dent. 2012;108(3):181–8. https://doi.org/10.1016/S0022-3913(12)60145-0.

    Article  PubMed  Google Scholar 

  25. Raico Gallardo YN, da Silva-Olivio IRT, Mukai E, Morimoto S, Sesma N, Cordaro L. Accuracy comparison of guided surgery for dental implants according to the tissue of support: a systematic review and meta-analysis. Clin Oral Implants Res. 2017;28(5):602–12. https://doi.org/10.1111/clr.12841.

    Article  PubMed  Google Scholar 

  26. Kernen F, Benic GI, Payer M, Schär A, Müller-Gerbl M, Filippi A, et al. Accuracy of three-dimensional printed templates for guided implant placement based on matching a surface scan with CBCT. Clin Implant Dent Relat Res. 2016;18(4):762–8. https://doi.org/10.1111/cid.12348.

    Article  PubMed  Google Scholar 

  27. Vermeulen J. The accuracy of implant placement by experienced surgeons: guided vs freehand approach in a simulated plastic model. Int J Oral Maxillofac Implants. 2017;32(3):617–24. https://doi.org/10.11607/jomi.5065.

    Article  PubMed  Google Scholar 

  28. Laederach V, Mukaddam K, Payer M, Filippi A, Kühl S. Deviations of different systems for guided implant surgery. Clin Oral Implants Res. 2017;28(9):1147–51. https://doi.org/10.1111/clr.12930.

    Article  CAS  PubMed  Google Scholar 

  29. Cassetta M, Bellardini M. How much does experience in guided implant surgery play a role in accuracy? A randomized controlled pilot study. Int J Oral Maxillofac Surg. 2017;46(7):922–30. https://doi.org/10.1016/j.ijom.2017.03.010.

    Article  CAS  PubMed  Google Scholar 

  30. Ewers R, et al. Computer aided navigation in dental implantology: 7 years of clinical experience. J Oral Maxillofac Surg. 2004;62:32–334.

    Article  Google Scholar 

  31. Strong EB, Rafii A, Holhweg-Majert B, Fuller SC, Metzger MC. Comparison of 3 optical navigation systems for computer-aided maxillofacial surgery. Arch Otolaryngol Head Neck Surg. 2008;134(10):1080–4. https://doi.org/10.1001/archotol.134.10.1080.

    Article  PubMed  Google Scholar 

  32. • Block MS, Emery RW. Static or dynamic navigation for implant placement: choosing the method of guidance. J Oral Maxillofac Surg. 2016;74:269–77. Describes workflow for static and dynamic navigation and indications for different navigation methods.

    Article  PubMed  Google Scholar 

  33. •• Block MS, et al. Implant placement accuracy using dynamic navigation. Int J Oral Maxillofac Implants. 2017;32:92. Demonstrates that dynamic navigation can achieve accuracy of implant placement similar to static guides and is an improvement over freehand implant placement.

    Article  PubMed  Google Scholar 

  34. Emery RW, Merritt SA, Lank K, Gibbs JD. Accuracy of dynamic navigation for dental implant placement–model-based evaluation. J Oral Implantol. 2016;42(5):399–405. https://doi.org/10.1563/aaid-joi-D-16-00025.

    Article  PubMed  Google Scholar 

  35. D'haese J, et al. Current state of the art of computer-guided implant surgery. Periodontol. 2000. 2017;73(1):121–33. https://doi.org/10.1111/prd.12175.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Amsterdam Dental Group, 100 South Broad Street Suite 2000, Philadelphia, Pa, 19110, USA

    Brian Kasten

  2. Penn Dental Medicine, Philadelphia, PA, USA

    Ali Arastu

  3. Department of Oral and Maxillofacial Surgery, Penn Presbyterian Medical Center, Philadelphia, PA, USA

    Neeraj Panchal

  4. Department of Oral and Maxillofacial Surgery, Philadelphia Veteran’s Affairs Medical Center, Philadelphia, PA, USA

    Neeraj Panchal

  5. Department of Oral Surgery/Pharmacology, Penn Dental Medicine, Philadelphia, PA, USA

    Neeraj Panchal

Authors
  1. Brian Kasten
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ali Arastu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Neeraj Panchal
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Brian Kasten.

Ethics declarations

Conflict of Interest

All authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Digital and Esthetic Dentistry

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kasten, B., Arastu, A. & Panchal, N. Dental Implant Surgery: From Conventional to Guided to Navigated Approach. Curr Oral Health Rep 5, 140–146 (2018). https://doi.org/10.1007/s40496-018-0182-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40496-018-0182-2

Keywords

Search

Navigation