Guided implant surgery has become one of the most important tools available in dentistry, providing results that yield more predictable restorative results. (Fig. 1) It is also one of the areas that we get the most questions about. In this article we will highlight three of the options available to clinicians who want to integrate guided surgery into their practice.
Before talking about guided workflows, it is important to preface my comments with an encouragement to get some basic training on these processes before jumping in solo. Even if you use a different workflow the feedback that we have received from our clients is that CAD-Ray.com offers excellent “jump-start” seminars on the basics of guided surgery. You will save yourself from making many mistakes of wasted time and resources by learning from Dr. Armen Mirzayan’s experience. CAD-Ray’s intro program will give you a head-start on which surgical kits to invest in, surgical planning and guide design tips, as well as practical surgical procedures that will keep you on solid clinical ground.
From our experience with our clients at Burbank Dental Lab, after fabricating over 9,000 guided surgery appliances in the last 3 years, we have seen what works well for the average clinician. What matters most to the doctors that we have worked with is Control and Options. The three workflows that offer greatest design control and fabrication choices are Blue Sky Plan, CAD-Ray.com, and SICAT’s DIGITALGUIDE.
"What matters most to the doctors that we have worked with is control and options."
--- TONY SEDLER, PRESIDENT
CAD-Ray is both an education and a design facilitation company. (Fig. 2, shown below) One of the most significant advantages of using CAD-Ray is that it is a peer to peer relationship, with on-staff practicing dentists involved in the evaluation, and design process at every step. You get the extra value of a learning experience as CAD-Ray’s team evaluates and gives you feedback on your CT scans, models (or) IOS scan, as well as surgical plan suggestions.
Ultimately you are in control, making the final approval of the surgical plan and guide design. Once approved the design is sent to Burbank Dental Lab for guide fabrication, guide ring placement, and finally shipping to your office within 48 hours.
Click here to download the CAD-Ray Guided Surgery Workflow PDF guide
Blue Sky Plan (BSP) software is a free open architecture software which allows you, the clinician, to plan your surgeries and design your own guided surgery appliances. CT scan and model scans are easily imported into BSP; the two files are then merged, and the mental nerve is identified and highlighted before planning surgery. (Fig. 3, shown below)
BSP is very intuitive to use allowing you to place virtual restorations, which assist you in preparing your implant placement in the ideal location and angulation that will accommodate the final restorative solutions. Once the plan and guide are complete, a .stl file can be exported (Blue Sky Rio charges $11-$20 per exported file.) and sent to Burbank Dental Lab for fabrication of your guide.
SICAT ( a Dentsply Sirona Company) is part of the Galaxis / Galileos Implant software workflow.
In the SICAT workflow, there are three distinct options: ClassicGuide, OptiGuide, and DITITALGUIDE. (Fig. 4) The latter is my focus as it can be produced by a local lab, such as Burbank Dental Lab, the two former are made by SICAT in Germany.
The SICAT DIGITALGUIDE uses 3D CT scan and merges it with the IOS optical scan of the teeth or a scan of the model. After the plan is complete, you can select DIGITALGUIDE and follow the workflow to the last page where you can choose the Partner Lab.
One of the distinct advantages to using SICAT in this process is that SICAT checks every case in regards to implementation in advance, and you are informed of any problems. Once SICAT approves the .stl file, it is sent to the partner lab for final fabrication and delivery to your office.
Burbank Dental Guided Surgery Appliances offer you a precision fit and quick turn-around time.
We can fabricate a “guided surgery appliance” from several different workflows, using state of the art digital printers and titanium guide cylinders that correspond to your surgical system. Whether you plan and design your guides or work with a third party that exports a .stl file of the designed guide, Burbank Dental Lab can fabricate a guide for you.
Detailed workflow charts for each of these three options are available from Burbank Dental Laboratory; you can request one or more the guides below: