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Treatment

Guided dental implants in Deerfield Beach

Your implant is planned on a CBCT scan (a 3D X-ray of your jaw) before the day of surgery, then placed through a custom guide made from that plan. The guide sets the implant's position, angle and depth, and when your bone and gum allow, the implant goes in through a small opening instead of an opened gum (a flapless approach).

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In short

What is guided implant surgery?

Guided implant surgery (static computer-aided implant surgery) plans each implant in software from a CBCT scan, often combined with a digital impression of your teeth. A surgical guide made from that plan then directs the drill, so the implant follows the planned path. Single and multiple implants at our office are planned and placed this way.

From the office of Dr. Angela Berkovich, DMD, Deerfield Beach · (954) 427-3000

Last updated

How a surgical guide sets the implant pathIllustration of a jaw in cross-section. A surgical guide rests on the gum. A sleeve in the guide lines up with a dashed planned path that runs down into the bone, and an implant sits along that path. Below the implant, the nerve canal is outlined with a shaded 2 mm safety margin around it.Planned pathGuide sleeveSurgical guideGumImplantJawboneNerve canal2 mm safety margin

How a surgical guide sets the implant path

Cross-section of the jaw, as an illustration. The sleeve in the guide holds the drill on the path planned from your CBCT scan. Across 20 clinical studies (2,238 implants), guided implants ended up on average 1.2 mm from the plan at entry, 1.4 mm at the tip and 3.5° in angle. The same review advises keeping a safety margin of at least 2 mm from structures such as the nerve canal.1,2

Planned from
A CBCT 3D scan, often merged with a digital impression1
Placed through
A surgical guide made from the digital plan1
Average deviation
1.2 mm at entry and 1.4 mm at the tip, across 2,238 implants2
Healing before the crown
The jawbone fuses to the implant over three to nine months9
Anesthesia
Local anesthesia; flapless when bone and gum allow1

Who guided implants are for

Guided planning is used for a single missing tooth and for several. It may suit you if:

  • You are missing a tooth, or have a tooth that needs to be replaced.
  • You are missing several teeth and want each implant planned around the others.
  • Your jawbone can hold an implant. The 3D scan shows this, and grafting may still be needed.
  • Your gums are healthy, or gum disease is treated first.

A flapless approach (no gum flap) isn't for everyone. It needs enough bone and firm gum tissue at the site, which your scan and exam will show.

How guided implant surgery works

  1. Scan

    A CBCT scan shows your jawbone in 3D. A digital impression records your teeth and gums.1

  2. Plan

    The implant's position, angle and depth are planned in software around your bone, nerves and neighboring teeth. We go through the plan with you before surgery.1

  3. Guide

    A surgical guide is printed from the plan. It fits over your teeth or gum and holds a sleeve that directs the drill. In fully guided surgery, every drill and the implant itself pass through the guide.1,3

  4. Place

    Under local anesthesia, the implant is placed through the guide. When bone and gum allow, that happens through a small opening, without a flap.1,5

  5. Heal, then restore

    Your jawbone fuses to the implant over several months. The abutment and crown go on once the implant has bonded to the bone.8,9

Guided and freehand placement, side by side

In randomized trials, implants placed either way survived at similar rates. The differences are in how the drill is directed and how closely the implant matches the plan.

Guided and freehand placement, side by side
AspectGuided (fully guided)Freehand
How the drill is directedThrough a sleeve in a guide made from your 3D plan1,3By hand, without a guide
Distance from the planLower deviation in a meta-analysis of randomized trials3On average about 0.65 mm more at entry, 1.13 mm more at the tip and 4.4° more in angle
Opening the gumFlapless is possible when bone and gum allow1,5The gum is often opened (a flap) so the bone can be seen
Implant survival at 12 monthsAbove 98% in trials3Similar
What can limit itHow wide you can open, and bone that needs grafting first6Bone that needs grafting first

Looking after the implant

  • Implants depend on healthy gums, so regular cleanings stay part of the plan.7

Questions patients ask

Will it hurt less?

Possibly. In a randomized trial of 60 patients, those who had flapless guided surgery felt pain less intensely and for a shorter time than those whose gum was opened with a flap. Reviews that pool several trials found no clear difference, so we don't count on it: plan for some soreness either way.3,4,5

Can every implant go in without opening the gum?

No. Flapless placement needs enough bone and firm gum tissue at the site, and it has to be done with great care. Your scan and exam show whether it suits you; if it doesn't, the gum is opened so the bone can be seen, and we explain what that means before the day of surgery.1

Will I need a bone graft?

Sometimes. The CBCT scan shows how much bone you have before anything is planned, so you know in advance whether a graft is part of your treatment. Guided planning does not remove the need for one: an implant still needs enough healthy bone and healthy gums.6,7

Does guided planning work for several missing teeth?

Yes, it is used for single and multiple implants, with each implant planned around the others. In the clinical studies reviewed, guided placement was more accurate when some natural teeth remained to seat the guide on than when a whole arch was missing.2

Who you'll see

Dr. Angela Berkovich, DMD

Dr. Angela Berkovich, DMD

Dentist, trained at Oregon Health & Science University School of Dentistry

At your consultation, Dr. Berkovich goes through your scan and the implant plan with you, including whether a flapless approach suits your bone and gum.

Medical content reviewed by Dr. Angela Berkovich, DMD on .

Office: 1348 E Hillsboro Blvd Suite A, Deerfield Beach, FL 33441. (954) 427-3000

About Dr. Berkovich

Sources

  1. PubMed: Wismeijer et al. 2018, ITI Group 5 consensus on computer-assisted implant surgery
  2. PubMed: Tahmaseb et al. 2018, accuracy of static computer-aided implant surgery
  3. PubMed: Tattan et al. 2020, guided versus freehand implant placement: meta-analysis of randomized trials
  4. PubMed: Joda et al. 2018, patient-reported outcomes of computer-assisted implant surgery
  5. PubMed: Fortin et al. 2006, pain after flapless guided versus open-flap implant surgery (randomized trial)
  6. PubMed: Jung et al. 2009, computer technology applications in implant dentistry
  7. American Academy of Periodontology: Dental implant procedures
  8. American Association of Oral and Maxillofacial Surgeons: Healing process for dental implants
  9. Cleveland Clinic: Dental implants

General information, not a diagnosis or a promise of results. Individual results vary, and whether a treatment suits you depends on your exam.

Talk it through at a consultation

Bring your questions and any X-rays you already have. We'll look at your teeth and explain whether this treatment is a reasonable option for you, and what else could be.

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