Ensuring predictability with surgical guides
Featured Products Promotional FeaturesPosted by: Dental Design 28th June 2022
Dr David Veige is one of several industry-leading clinicians to have recorded a webinar for ADI members, all of which are included free as part of membership. More than qualified for the job, David has an MSc in Dental Implantology and is a widely renowned clinician, mentor and lecturer. His webinar explores “The Power of Guided Surgery”, exploring the basics of guided surgery, alongside different workflows and case scenarios. Discussing the benefits of guided surgery, when done right, he comments:
“Guided surgery is all about pre-planning for enhanced predictability of dental implant treatment. It provides an opportunity to run through the surgical procedure in your head and be prepared. As the clinician, you get an idea of where the future prosthetic envelope needs to be so that a surgical guide can be created to deliver the implant within the restorative confines. The benefit is that the pre-determined steps prevent the need to figure out what you need to do as you’re doing it.”
As many clinicians will know, the use of surgical guides has increased substantially in the past decade or two. David considers their accessibility now compared to just ten years ago:
“When the concept of guided surgery first came out, people thought it was complex. There were a lot of computer steps, moving around and analysing files. Technology has since evolved and caught up with us, so our manufacturing is much better than it was. Ten years ago, 3D printing offered nothing like the results we can achieve today. Costs have also come down significantly, making it far more cost effective. For context, one of the first guides I ever 3D printed – a single-tooth guide – was £600. I can print the same guide now for £5, so it is no longer cost-prohibitive for clinicians or patients.”
Despite the massive improvements in technology and techniques, guided surgery is not without its challenges. Being aware of these and knowing how to avoid issues is integral to achieving optimal outcomes.
“The biggest challenge is gathering the correct data,” David continues. “Comprehensive assessment of the patient and understanding the digital workflow will help you get data in the correct format to produce effective surgical guides. Complications can occur when metal artifacts obscure the CBCT scan, but it is possible to adapt your workflow. Getting the right data ensures a highly accurate process – today I can fabricate the final restoration to fit on the day of surgery, which was not possible with traditional techniques.”
For clinicians looking to develop their skills with guided surgery, David offers some advice on where to start:
“I would recommend downloading some free software and watching how-to videos on YouTube – I offer some on my channel. I think the learning curve is relatively short as you are mostly just familiarising yourself with the buttons and software functionality. Digital dentistry is amazing but it not a silver bullet, so it’s always crucial to remain within your clinical ability. It’s important to maintain the analogue skills as these are critical to check that surgical guides are seating correctly on a model or in the mouth. Where they don’t fit perfectly, they must be adjusted. In my experience, 99% of surgical guides are prefect first time, but it does take time to get the right techniques with the equipment. It’s about understanding your specific technology. As such, I would recommend those new to the field invest in simple to use equipment that is easy to set up. Surgical guides also work best where they are supported by teeth in the mouth.”
As part of his ADI webinar, David will also consider the use of surgical guides for full arch rehabilitations. He says:
“Surgical guides for full arch restorations are supported by the bone, soft tissue or teeth, which means that an extra step is required to obtain the relevant data with segmentation of the CT scan to create a bone model. From here, you fabricate the surgical guide to fit directly. To place the guide on the bone, a flap must be raised, so it’s important that the clinician is capable and confident with this technique. Good access to the bone is essential to allow the guide to seat properly, otherwise surgery can be unpredictable. When done correctly, this workflow produces very accurate implant placements to allow the correct prosthetic envelope and space for restoration.”
The webinars are just one of many membership benefits available through the ADI. However, the organisation is much more than the first-class education it offers – it is also a community, as David goes on to highlight:
“What I love most about the ADI compared to other dental implant organisations is that everyone is working in the UK – you have direct access to people around you. The international organisations are great, but members are all over the place. For a young dentist wanting to get involved in dental implants, the ADI is place to be. You could have really experienced clinicians just down the road and that can be a very powerful learning opportunity.”
Become a member today to utilise David’s and many other webinars, as well as several further benefits to aid in your career progression.
For more information about the ADI, or to join, please visit the website
