| Preoperative imaging/impression |
CBCT & Diagnostic impression/Oral scanner |
CBCT |
| Devices required |
Surgical guide, Surgical motor, Piezosurgical unit, Dental operating microscope, Periapical instruments, Surgical instruments |
Hand piece attachment, patient jaw attachment, the system cart consisting camera, computer with navigation software and natural or fiducial markers |
| Working protocol |
Imaging, Image registration/merging, Surgical plan, Final digital plan, Template fabrication, Try on, Guided surgery |
Plan, Trace, Drill |
| Operator accessibility |
Limited and not possible to modify treatment plan once the guide is fabricated |
Good and possible to modify procedure plan at any time of treatment |
| Accuracy |
Comparatively less |
More |
| Advantages |
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Accurate details and reproduction of scan providing good quality of work and consistent results
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•
It is possible to print complex geometric shapes and interlocking parts that require no assembly
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•
Reduction of production-related material loss
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It is possible to produce single objects in small quantities at low cost and fast delivery
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•
Errorless and superior in accuracy
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•
Reduces potential risk of damaging critical structures
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•
Greater flexibility offered to the operator
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Adjustments dictated by clinical situation can be made to the working plan at any time
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| Disadvantages |
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Possibilities of inaccuracy in image registration and 3D printing
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•
Crescent shape of resected root apex
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Larger deviations, Over penetration
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•
Trephine fracture
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Lack of long term success
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3D guides are not re-useable
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•
Resin guides cannot be heat sterilized, Resin used in messy condition can cause inflammation and irritation on contact and inhalation
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Longer surgical time
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More steps & Learning curve
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Possible inaccuracies during registration
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Entire procedure is supervised by computer software; any time lag for processing commands in computer might lead to iatrogenic errors.
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