Short answer
A surgical guide is a 3D-printed, tooth-supported template that steers the drill to the planned implant position, built from the CBCT merged with the intraoral scan. In a 2018 meta-analysis, mean deviation was 1.2 mm at entry and 1.4 mm at the apex, so the 2 mm safety margin still applies.
What it is
A 3D-printed template that seats on the remaining teeth and has a channel for the drill at each implant site. It carries the position, angle and depth planned on screen into surgery.
The guide is designed on the arch scan merged with the CBCT. Where the implants go is your clinical call. Who runs the virtual planning (you, or the lab with your approval), which guided surgery kit it has to fit, and fully edentulous cases with a mucosa-supported guide are all agreed when the case is opened.
When to use it
A guide matters most when the restoration dictates where the implant should go. The ITI consensus on static computer-aided implant surgery recommends a prosthetically driven approach and designing the guide on the surface scan merged with the DICOM data.
It doesn’t remove error. In the meta-analysis by Tahmaseb and colleagues (Clinical Oral Implants Research, 2018), across 20 clinical studies, mean deviation was 1.2 mm at entry, 1.4 mm at the apex and 3.5° in angle. Accuracy was better in partially edentulous arches. The recommendation is to stay 2 mm clear of critical anatomy.
How we make it
The guide is designed on the aligned CBCT and scan and printed in our lab in São Paulo, Brazil. Every stage is validated and logged before the guide ships, the box carries the case number, and you follow its phase in the portal.
What to send
The basics are in our case submission guide. For a surgical guide, the merge is what matters most. The scan needs the full arch with no distortion on the supporting teeth (see our scanning guide), and the CBCT needs to be free of artifacts in that area. After surgery, send the guide along with the implant crown case.
Frequently asked questions
How accurate is a surgical guide?
In the 2018 meta-analysis by Tahmaseb and colleagues, covering 2,238 implants, mean deviation was 1.2 mm at entry, 1.4 mm at the apex and 3.5° in angle. The authors consider this clinically acceptable in most cases, with a safety margin of at least 2 mm.
What files do I need to send?
The CBCT in DICOM and an intraoral scan of the arch, with the opposing arch. The ITI consensus recommends designing the guide on the surface scan merged with the DICOM data, and that is how it's built.
Is a guide as accurate in a fully edentulous arch?
According to the ITI consensus, accuracy is better in partially edentulous cases than in fully edentulous ones. For full-arch cases, it's worth talking the case through with us before planning.
After surgery, do I send the guide with the restorative case?
Yes. For guided cases, the guide used at surgery is part of what we ask for on the implant restoration, along with the implant brand and platform.
Sources
- The accuracy of static computer-aided implant surgery: a systematic review and meta-analysis · Clinical Oral Implants Research (2018)
- Accuracy of static computer-aided implant surgery (consensus statements and clinical recommendations) · ITI Academy