If there is one thing I simply don’t understand is why more dentists aren’t utilizing guided surgery for implant placement. There are two main reasons that I consistently hear:
- I don’t need guided surgery as I have been getting great results by free handed placement.
- Guided surgery is an unnecessary cost.
Let me address #1 above first.
You are absolutely right – you don’t NEED guided surgery. And you are right that you get good (not consistently great) results using free handed placement.
But the bar is shifting and the expectations are changing. The precision afforded by guided surgery is rapidly making a big difference. To give a specific example, guided surgery makes immediate placement (right after extraction) more likely than not. In our practice we have found that nearly 60% of the implants placed are immediate placement.
And truthfully, the vast majority of those who say free handed placement is more than adequate are not restoring their implant placements. So they never really have the benefit of seeing some of the complications their ‘free hand’ placement can create.
Now for #2.
It costs money. Of course it does. But it’s very shortsighted to focus on the physical cost of a surgical guide.
Today a guide can be fabricated for around $60 in office utilizing CAD/CAM technology. If you have a printer you can make a surgical guide for about $30 in office. Through a lab the guide will cost between $250-$400.
But the real savings comes in the form of TIME. I can’t seem to get this message across to dentists fast enough – THE MOST EXPENSIVE OVERHEAD ITEM YOU HAVE IS TIME!
When I am placing a case guided my surgical time of actually placing the implant is about 10 minutes. When I do a case freehand it comes in at nearly 30 minutes. There are x-rays and other verification steps that I am able to forego when utilizing the safety and precsion of guided surgery.
While talking about precision. Precision can also be a time and cost savings. Let’s take a look at the below image.
The above image is a perfect example. Tooth #8 is going to be a screw retained restoration. Tooth #9 will need to be a custom abutment and crown. The precision of being able to plan and then guide the implant to within degrees will allow me to make #9 a screw retained restoration as well.
So what is the savings here? A custom abutment adds an additional $400-$500 in lab costs (per tooth) to me and the patient. This aspect completely dwarfs the few dollars that I would spend on the guide.
If you are placing implants it’s time to start looking at surgical guides as a time and cost savings, not an increase in cost.
If you are having someone else place your implants, it’s time to ask that person to utilize guided surgery to have the precision to control the placement to allow more screw retained restorations. This will save you time and money.
If you are a CEREC owner and are not utilizing your machine to fabricate your implant restorations (custom abutments and screw retained crowns) please consider taking some training. We offer a great program that covers this in great detail.
If you are a Sirona 3D CBCT owner with CEREC technology and you aren’t completing your cases in 2-3 visits from start to finish in about 60-90 minutes of total chair time then consider attending our Ultimate 3D Workshop. We will share with you how to attain excellent results in less time.