Additivemanufacturing is becoming increasingly important in dentistry for the in office production ofsurgical guides. The development of cost-effective desktop stereolithography(SLA) printing systems and the corresponding resins makes this novel techniqueaccessible to dental offices and dental laboratories. Furthermore, guidedsurgical drills which do not provide metallic sleeves could make even simplerall the process.
Recently published study has found that implantsurgical guides produced using in office printing system could be a “convenient,cost-effective, and an accurate means of providing implant surgery for patients (Deeb 2017).Although promising results, final implant accuracy and templatebiocompatibility remain the main concerns. In fact, the same study also confirmed thatthere is little loss in accuracy for in-house printed guides (Deeb 2017).Another study confirm that biocompatibility of the resins used for fabricationof surgical template depends by the processing stages of the materials, and meticulousadherence to processing guidelines, especially postcuring, is of clinicalrelevance (Kurzmann 2017). Hence, there is still lack of evidence to suggest the in officeproduction of surgical guides.
Moreover, lack of pre- and post-quality control have totaken into account.Today, evidence-based methods forplacing implants include both freehand approach, and laboratory or computer-aideddesign/computer-aided manufacturing generated static guide stents that areeither tooth, mucosa, or bone supported. Looking at the future, dynamicnavigation/guidance could be use to visualize implant site developmentwhile the drills are in function. Major advantages are the deviations fromthe predetermined plan can be seen in “real time” and changes to the original plan can be madeat the time of surgery.
Full guidance is possible, as real-time visualizationand adjustment of position can be made at any time. Dynamicnavigation systems can achieve accuracy of implant placement similar tostatic guides and is an improvement over freehand implant placement (Block 2016). Nevertheless, there was alearning curve to achieve proficiency. At now, clinical reportsare still limited, but implant integration rates seems to be similar tothose of conventional drilling methods.